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General NPI Number Information
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NPI Number | 1467437657
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Entity Type | Organization
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Legal Business Name | REBOUND PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 203 OAK ST LONGFELLOW SPORTS CLUB
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City | NATICK
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State | MA
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Zip | 01760-1306
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Country | US
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Telephone | 508-651-0051
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Fax | 508-651-0061
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Provider Business Mailing Address
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Address Line | 203 OAK ST
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City | NATICK
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State | MA
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Zip | 01760-1306
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Country | US
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Telephone | 508-651-0051
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Fax | 508-651-0061
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | STEPHEN R CROWELL
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Credential | MSPT
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Telephone | 508-651-0051
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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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