Provider Demographics
NPI:1629082045
Name:ABSOLUTE REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:ABSOLUTE REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:228-818-2636
Mailing Address - Street 1:5935 WASHINGTON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2642
Mailing Address - Country:US
Mailing Address - Phone:228-818-2636
Mailing Address - Fax:228-818-2637
Practice Address - Street 1:5935 WASHINGTON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-2642
Practice Address - Country:US
Practice Address - Phone:228-818-2636
Practice Address - Fax:228-818-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT0286225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty