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NPI Code Detail

MEDICARE: POWERBACK REHABILITATION LLC

MEDICARE: POWERBACK REHABILITATION 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
1261Q00000XClinic/Center
2261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1881093912
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 : 3260 N HARBOR CITY BLVD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-6203
Country : US
Telephone Number : 321-241-4934
Fax Number :
Authorized Official
Title or Position : COO
Name : IAN OPPEL
Credential :
Telephone Number : 980-254-7007
Provider Enumeration Date : 08/14/2014
Last Update Date : 04/03/2025

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Directions to “POWERBACK REHABILITATION LLC ” Practice Location

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