Provider Demographics
NPI:1073851523
Name:REBOUND PHYSICAL THERAPY &WELLNESS
Entity Type:Organization
Organization Name:REBOUND PHYSICAL THERAPY &WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REHAB
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DOUGALEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-333-0679
Mailing Address - Street 1:23 EDGEWOOD ACRES
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-2859
Mailing Address - Country:US
Mailing Address - Phone:724-333-0679
Mailing Address - Fax:
Practice Address - Street 1:23 EDGEWOOD ACRES
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-2859
Practice Address - Country:US
Practice Address - Phone:724-333-0679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019526225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty