Healthcare Provider Details

I. General information

NPI: 1477961209
Provider Name (Legal Business Name): FABREHAB SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

676 MIAMI ST
TIFFIN OH
44883-1934
US

IV. Provider business mailing address

407 E AUGLAIZE ST
WAPAKONETA OH
45895-1607
US

V. Phone/Fax

Practice location:
  • Phone: 419-448-5533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number07630
License Number StateOH

VIII. Authorized Official

Name: MR. JARRET R WEBB
Title or Position: PTA
Credential: PTA
Phone: 419-230-0584