Healthcare Provider Details

I. General information

NPI: 1215010434
Provider Name (Legal Business Name): REHABILITATIVE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HARCOURT RD SUITE 1
MOUNT VERNON OH
43050-3946
US

IV. Provider business mailing address

112 HARCOURT RD SUITE 1
MOUNT VERNON OH
43050-3946
US

V. Phone/Fax

Practice location:
  • Phone: 740-392-8811
  • Fax: 740-392-6485
Mailing address:
  • Phone: 740-392-8811
  • Fax: 740-392-6485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT TIELL
Title or Position: PARTNER
Credential:
Phone: 740-392-8811