Provider Demographics
NPI:1447566310
Name:REBOUND PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:REBOUND PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:508-651-0051
Mailing Address - Street 1:203 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1306
Mailing Address - Country:US
Mailing Address - Phone:508-651-0051
Mailing Address - Fax:508-651-0061
Practice Address - Street 1:54 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-3208
Practice Address - Country:US
Practice Address - Phone:617-658-2244
Practice Address - Fax:617-658-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-29
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA529261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine