Provider Demographics
NPI:1043822851
Name:VALLEY REHABILITATION & PERFORMANCE
Entity Type:Organization
Organization Name:VALLEY REHABILITATION & PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:POMFRET
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:812-645-7100
Mailing Address - Street 1:1219 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-3923
Mailing Address - Country:US
Mailing Address - Phone:812-645-7100
Mailing Address - Fax:812-645-7900
Practice Address - Street 1:1219 OHIO ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-3923
Practice Address - Country:US
Practice Address - Phone:812-645-7100
Practice Address - Fax:812-645-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty