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General NPI Number Information
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NPI Number | 1114727476
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Entity Type | Organization
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Legal Business Name | POWERBACK REHABILITATION LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 8875 GREEN MEADOWS DR N
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City | LEWIS CENTER
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State | OH
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Zip | 43035-9447
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Country | US
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Telephone | 740-909-6014
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E STATE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3109
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Country | US
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Telephone | 800-728-8808
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Fax | 610-347-4147
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Authorized Official
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Title or Position | COO
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Name | IAN OPPEL
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Credential |
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Telephone | 980-254-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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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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