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General NPI Number Information
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NPI Number | 1356752208
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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 | 05/14/2014
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 2085 WAYNE RD C/O PROVIDENCE PLACE OF CHAMBERSBURG
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City | CHAMBERSBURG
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State | PA
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Zip | 17202-8586
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Country | US
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Telephone | 717-261-4137
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E STATE ST C/O AMY NUNEMAKER
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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 | 610-925-4560
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CARL ANTHONY SHROM
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Credential |
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Telephone | 215-896-0422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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