MEDICARE: QUALITY REHAB INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center
2	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124276217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY REHAB INC

Provider Business Mailing Address
First Line	:	3604 GALLEY RD
Second Line	:	STE 200
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-4302
Country	:	US
Telephone Number	:	719-550-4613
Fax Number	:	719-375-8426

Provider Business Practice Location Address
First Line	:	3604 GALLEY RD
Second Line	:	STE 200
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-4302
Country	:	US
Telephone Number	:	719-550-4613
Fax Number	:	719-375-8426

Authorized Official
Title or Position	:	CEO/ OWNER
Name	:	JASON YISU PARK
Credential	:	PT, DPT
Telephone Number	:	719-550-4613

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	09/08/2022

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Directions to “QUALITY REHAB INC ” Practice Location

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