Provider Demographics
NPI:1861689614
Name:REHAB SPECIALISTS, LLC
Entity Type:Organization
Organization Name:REHAB SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-282-3697
Mailing Address - Street 1:6995 S 400 W
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1012
Mailing Address - Country:US
Mailing Address - Phone:801-654-1774
Mailing Address - Fax:801-280-3933
Practice Address - Street 1:6995 S 400 W
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1012
Practice Address - Country:US
Practice Address - Phone:801-654-1774
Practice Address - Fax:801-280-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6035160001Medicare NSC