Healthcare Provider Details
I. General information
NPI: 1962520056
Provider Name (Legal Business Name): PENN REHAB NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 STOOPS DRIVE SUITE 380
MONONGAHELA PA
15063
US
IV. Provider business mailing address
100 STOOPS DRIVE SUITE 380
MONONGAHELA PA
15063
US
V. Phone/Fax
- Phone: 724-483-4268
- Fax:
- Phone: 724-483-4268
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224Z00000X |
| Taxonomy | Occupational Therapy Assistant |
| License Number | OC004380L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | PT002017L |
| License Number State | PA |
VIII. Authorized Official
Name:
DENVER
BYRON
Title or Position: OT, CO-OWNER
Credential: OT
Phone: 724-483-4263