Provider Demographics
NPI:1467437657
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/DIRECTOR
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 1:203 OAK ST
Practice Address - Street 2:LONGFELLOW SPORTS CLUB
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1306
Practice Address - Country:US
Practice Address - Phone:508-651-0051
Practice Address - Fax:508-651-0061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1078657OtherAETNA
MA621300OtherTUFTS
MAAA45429OtherHARVARD PILGRIM
MA0000Y61432OtherBCBS
MA8077207OtherCIGNA/TUFTS LOGO
MA0000Y61432OtherBCBS
MA=========OtherCOMMONWEALTH INDEMNITY
MAAA45429OtherHARVARD PILGRIM
MA=========OtherOXFORD
MA1078657OtherAETNA
MA8077207OtherCIGNA/TUFTS LOGO
MA=========OtherHCVM