Provider Demographics
NPI:1639669799
Name:ZOOM REHABILITATION,INC
Entity Type:Organization
Organization Name:ZOOM REHABILITATION,INC
Other - Org Name:ZOOM PHYSICAL THERAPY AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFKA
Authorized Official - Suffix:
Authorized Official - Credentials:BS,PTA
Authorized Official - Phone:361-582-2110
Mailing Address - Street 1:9606 NE ZAC LENTZ PKWY
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3115
Mailing Address - Country:US
Mailing Address - Phone:361-582-2110
Mailing Address - Fax:361-541-4411
Practice Address - Street 1:300 N VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:PORT LAVACA
Practice Address - State:TX
Practice Address - Zip Code:77979-3449
Practice Address - Country:US
Practice Address - Phone:361-552-5400
Practice Address - Fax:361-552-5406
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZOOM REHABILITATION,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation