Provider Demographics
NPI:1003266446
Name:PHYSICAL REHAB SERVICES
Entity Type:Organization
Organization Name:PHYSICAL REHAB SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:828-606-6683
Mailing Address - Street 1:3108 LAKE ADGER RD
Mailing Address - Street 2:
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756-5830
Mailing Address - Country:US
Mailing Address - Phone:828-625-0400
Mailing Address - Fax:828-625-0740
Practice Address - Street 1:3108 LAKE ADGER RD
Practice Address - Street 2:
Practice Address - City:MILL SPRING
Practice Address - State:NC
Practice Address - Zip Code:28756-5830
Practice Address - Country:US
Practice Address - Phone:828-625-0400
Practice Address - Fax:828-625-0740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP4217225100000X, 225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty