Healthcare Provider Details
I. General information
NPI: 1346190444
Provider Name (Legal Business Name): SYNERGY REHAB SCOTTSBLUFF LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1930 E 20TH PL STE 100A
SCOTTSBLUFF NE
69361-2874
US
IV. Provider business mailing address
PO BOX 1244
MOUNTAIN VIEW WY
82939-1244
US
V. Phone/Fax
- Phone: 307-780-8331
- Fax:
- Phone: 307-780-8331
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAREN
MARTIN
Title or Position: MANAGING MEMBER
Credential: MPT
Phone: 307-780-8331