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General NPI Number Information
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NPI Number | 1295153823
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Entity Type | Organization
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Legal Business Name | PHYSICAL RESOLUTION HOME BASED REHABILITATION SERVICES INC
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Dates
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Enumeration Date | 04/01/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 3841 MANCHESTER DR
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City | BETTENDORF
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State | IA
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Zip | 52722-1935
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Country | US
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Telephone | 563-424-1733
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Fax | 563-424-1734
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Provider Business Mailing Address
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Address Line | PO BOX 25
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City | BETTENDORF
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State | IA
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Zip | 52722-0001
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Country | US
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Telephone | 563-424-1733
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Fax | 563-424-1734
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Authorized Official
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Title or Position | CFO
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Name | CAROLINE HASSIG
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Credential |
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Telephone | 563-424-1733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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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 | 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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