Provider Demographics
NPI:1790844959
Name:ROCKFORD HYPERBARIC HEALING CENTER, INC
Entity Type:Organization
Organization Name:ROCKFORD HYPERBARIC HEALING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-395-1450
Mailing Address - Street 1:4753 MANHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2264
Mailing Address - Country:US
Mailing Address - Phone:815-395-1450
Mailing Address - Fax:815-395-1459
Practice Address - Street 1:4753 MANHATTAN DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2264
Practice Address - Country:US
Practice Address - Phone:815-395-1450
Practice Address - Fax:815-395-1459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty