Healthcare Provider Details

I. General information

NPI: 1871737122
Provider Name (Legal Business Name): REBOUND PHYSICAL THERAPY II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 NE CUSHING DR SUITE 150
BEND OR
97701-3887
US

IV. Provider business mailing address

805 SW INDUSTRIAL WAY SUITE 3
BEND OR
97702-1093
US

V. Phone/Fax

Practice location:
  • Phone: 541-585-2529
  • Fax: 541-585-2536
Mailing address:
  • Phone: 541-585-2529
  • Fax: 541-585-2536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER RICHARDSON
Title or Position: MED BILLING & INSURANCE MANAGER
Credential:
Phone: 541-585-2529