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NPI Code Detail

MEDICARE: SUNDANCE REHABILITATION AGENCY, LLC

MEDICARE: SUNDANCE REHABILITATION AGENCY, 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
1225100000XPhysical Therapist
2261QR0400XRehabilitation Clinic/CenterMA

General Provider Information

NPI Number : 1740341395
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNDANCE REHABILITATION AGENCY, LLC
Provider Business Mailing Address
First Line : 101 E STATE STREET
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 : 50 W MAIN ST
Second Line :
City : HOPKINTON
State : MA
Zip : 01748-1672
Country : US
Telephone Number : 508-435-1250
Fax Number : 508-435-2213
Authorized Official
Title or Position : SVP
Name : LOUISE ANN SOIKA
Credential :
Telephone Number : 610-925-4088
Provider Enumeration Date : 12/13/2006
Last Update Date : 02/23/2018

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