Healthcare Provider Details

I. General information

NPI: 1366088072
Provider Name (Legal Business Name): KUEHNEL REHABILITATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2019
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1887 N STATE HIGHWAY CC
NIXA MO
65714-8015
US

IV. Provider business mailing address

4789 E TRAILWOOD WAY
SPRINGFIELD MO
65809-4319
US

V. Phone/Fax

Practice location:
  • Phone: 417-725-5774
  • Fax:
Mailing address:
  • Phone: 417-225-8664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TODD KUEHNEL
Title or Position: OWNER
Credential: PT
Phone: 417-234-1612