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General NPI Number Information
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NPI Number | 1821395369
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Entity Type | Organization
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Legal Business Name | REHAB REVOLUTION INC.
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Dates
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Enumeration Date | 02/18/2011
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 3936 CROSSWINDS DRIVE
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City | ROCKY MOUNT
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State | NC
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Zip | 27803
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Country | US
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Telephone | 252-452-9701
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Fax | 252-467-1377
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Provider Business Mailing Address
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Address Line | 3936 CROSSWINDS DRIVE
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City | ROCKY MOUNT
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State | NC
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Zip | 27803
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Country | US
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Telephone | 252-452-9701
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Fax | 252-467-1377
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | JEFFERY BEAL
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Credential | PT
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Telephone | 252-452-9701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2913
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 2942
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License Number State | NC
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