Provider Demographics
NPI:1609328913
Name:REBOUND MOBILE THERAPY, PLLC
Entity Type:Organization
Organization Name:REBOUND MOBILE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:269-720-7673
Mailing Address - Street 1:3822 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-8559
Mailing Address - Country:US
Mailing Address - Phone:269-720-7673
Mailing Address - Fax:936-449-1469
Practice Address - Street 1:3822 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-8559
Practice Address - Country:US
Practice Address - Phone:269-720-7673
Practice Address - Fax:936-449-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1165378261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy