Provider Demographics
NPI:1497057913
Name:RIVERWALK REHAB INC
Entity Type:Organization
Organization Name:RIVERWALK REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:563-823-8836
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:BLUE GRASS
Mailing Address - State:IA
Mailing Address - Zip Code:52726-0415
Mailing Address - Country:US
Mailing Address - Phone:563-823-8836
Mailing Address - Fax:563-823-8305
Practice Address - Street 1:1134 FRONT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:IA
Practice Address - Zip Code:52728-7763
Practice Address - Country:US
Practice Address - Phone:563-823-8836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-04
Last Update Date:2012-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy