Provider Demographics
NPI:1790981033
Name:PARK REHAB, INC.
Entity Type:Organization
Organization Name:PARK REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:T
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:740-927-6782
Mailing Address - Street 1:14176 NATIONAL RD SW
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3363
Mailing Address - Country:US
Mailing Address - Phone:740-927-6782
Mailing Address - Fax:
Practice Address - Street 1:14176 NATIONAL RD SW
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43068-3363
Practice Address - Country:US
Practice Address - Phone:740-927-6782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-24
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0045142251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty