Provider Demographics
NPI:1760256911
Name:REBOUND PAIN MANAGEMENT & REHABILITATION, LLC
Entity Type:Organization
Organization Name:REBOUND PAIN MANAGEMENT & REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-244-4080
Mailing Address - Street 1:3121 PONDER DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-5830
Mailing Address - Country:US
Mailing Address - Phone:214-244-4080
Mailing Address - Fax:
Practice Address - Street 1:3121 PONDER DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-5830
Practice Address - Country:US
Practice Address - Phone:214-244-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty