Provider Demographics
NPI:1619512845
Name:REBOUND CHIROPRACTIC AND SPORTS MEDICINE, LLC
Entity Type:Organization
Organization Name:REBOUND CHIROPRACTIC AND SPORTS MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:515-500-6551
Mailing Address - Street 1:1201 SW STATE ST STE 111
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2672
Mailing Address - Country:US
Mailing Address - Phone:785-458-2527
Mailing Address - Fax:
Practice Address - Street 1:1201 SW STATE ST., SUITE 111
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-5002
Practice Address - Country:US
Practice Address - Phone:515-500-6551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center