Provider Demographics
NPI:1194025452
Name:REHAB-BRAY LLC
Entity Type:Organization
Organization Name:REHAB-BRAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:740-264-0772
Mailing Address - Street 1:2716 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1155
Mailing Address - Country:US
Mailing Address - Phone:740-264-0772
Mailing Address - Fax:740-264-0771
Practice Address - Street 1:2716 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1155
Practice Address - Country:US
Practice Address - Phone:740-264-0772
Practice Address - Fax:740-264-0771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT073002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty