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General NPI Number Information
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NPI Number | 1043822851
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Entity Type | Organization
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Legal Business Name | VALLEY REHABILITATION & PERFORMANCE
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 1219 OHIO ST
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City | TERRE HAUTE
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State | IN
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Zip | 47807-3923
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Country | US
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Telephone | 812-645-7100
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Fax | 812-645-7900
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Provider Business Mailing Address
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Address Line | 1219 OHIO ST
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City | TERRE HAUTE
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State | IN
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Zip | 47807-3923
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Country | US
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Telephone | 812-645-7100
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Fax | 812-645-7900
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Authorized Official
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Title or Position | CEO
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Name | ADAM G POMFRET
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Credential | DPT
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Telephone | 812-645-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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