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General NPI Number Information
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NPI Number | 1689066615
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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 | 02/27/2015
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 345 FIVE FORKS RD
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-6806
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Country | US
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Telephone | 864-920-0189
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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 | 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 | 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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