MEDICARE: POWERBACK REHABILITATION LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1194702720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POWERBACK REHABILITATION LLC

Provider Business Mailing Address
First Line	:	101 E STATE ST
Second Line	:	C/O AMY NUNEMAKER
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-3109
Country	:	US
Telephone Number	:	610-925-4560
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 BERNARDSVILLE RD
Second Line	:
City	:	MENDHAM
State	:	NJ
Zip	:	07945-2923
Country	:	US
Telephone Number	:	973-813-0006
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	IAN OPPEL
Credential	:
Telephone Number	:	980-254-7007

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	07/02/2025

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Directions to “POWERBACK REHABILITATION LLC ” Practice Location

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