MEDICARE: INTEGRITY REHAB LLC

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	235Z00000X	Speech-Language Pathologist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1265191480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRITY REHAB LLC

Provider Business Mailing Address
First Line	:	1046 N WEBSTER ST
Second Line	:
City	:	RED CLOUD
State	:	NE
Zip	:	68970-2130
Country	:	US
Telephone Number	:	308-440-2887
Fax Number	:

Provider Business Practice Location Address
First Line	:	1046 N WEBSTER ST
Second Line	:
City	:	RED CLOUD
State	:	NE
Zip	:	68970-2130
Country	:	US
Telephone Number	:	308-440-2887
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MATTHEW KENNY
Credential	:	DPT
Telephone Number	:	308-440-2887

Provider Enumeration Date	:	12/15/2021
Last Update Date	:	12/15/2021

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Directions to “INTEGRITY REHAB LLC ” Practice Location

Language	Start Address	Practice Location

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