Provider Demographics
NPI:1235682451
Name:INBOX FUNCTIONAL REHAB, LLC
Entity Type:Organization
Organization Name:INBOX FUNCTIONAL REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-322-7347
Mailing Address - Street 1:2825 BURGESS LN
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63143-2801
Mailing Address - Country:US
Mailing Address - Phone:618-322-7347
Mailing Address - Fax:314-932-2394
Practice Address - Street 1:1099 MILWAUKEE ST
Practice Address - Street 2:240
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-7356
Practice Address - Country:US
Practice Address - Phone:314-822-1502
Practice Address - Fax:314-821-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty