Provider Demographics
NPI:1821395369
Name:REHAB REVOLUTION INC.
Entity Type:Organization
Organization Name:REHAB REVOLUTION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:252-452-9701
Mailing Address - Street 1:3936 CROSSWINDS DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803
Mailing Address - Country:US
Mailing Address - Phone:252-452-9701
Mailing Address - Fax:252-467-1377
Practice Address - Street 1:3936 CROSSWINDS DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27803
Practice Address - Country:US
Practice Address - Phone:252-452-9701
Practice Address - Fax:252-467-1377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2942261QP2000X
NC2913261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy