Provider Demographics
NPI:1568696169
Name:PER DIEM INC
Entity Type:Organization
Organization Name:PER DIEM INC
Other - Org Name:ABILITY REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPY ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KISER
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:606-833-9361
Mailing Address - Street 1:PO BOX 937
Mailing Address - Street 2:
Mailing Address - City:FLATWOODS
Mailing Address - State:KY
Mailing Address - Zip Code:41139-0937
Mailing Address - Country:US
Mailing Address - Phone:606-833-9361
Mailing Address - Fax:606-836-7561
Practice Address - Street 1:2611 GREENBO BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:FLATWOODS
Practice Address - State:KY
Practice Address - Zip Code:41139-1830
Practice Address - Country:US
Practice Address - Phone:606-833-9361
Practice Address - Fax:606-836-7561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008539225100000X
OH06702225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty