MEDICARE: MOBILE REHAB PLLC

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	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1568057917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE REHAB PLLC

Provider Business Mailing Address
First Line	:	3810 CLAIRMONT RD
Second Line	:
City	:	BISMARK
State	:	ND
Zip	:	58503
Country	:	US
Telephone Number	:	406-939-3848
Fax Number	:

Provider Business Practice Location Address
First Line	:	3810 CLAIRMONT RD
Second Line	:
City	:	BISMARK
State	:	ND
Zip	:	58503
Country	:	US
Telephone Number	:	406-939-3848
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MR. MATTHEW GEORGE LEBLANC
Credential	:	PT
Telephone Number	:	406-939-3848

Provider Enumeration Date	:	03/08/2021
Last Update Date	:	03/08/2021

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Directions to “MOBILE REHAB PLLC ” Practice Location

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