MEDICARE: REHAB TO HEALTH 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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1477385193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB TO HEALTH LLC

Provider Business Mailing Address
First Line	:	1785 E SOCIAL ROW RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-4728
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1785 E SOCIAL ROW RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-4728
Country	:	US
Telephone Number	:	937-901-3934
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LYNN RICHARDSON
Credential	:	DO
Telephone Number	:	937-901-3934

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	08/20/2024

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Directions to “REHAB TO HEALTH LLC ” Practice Location

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