Provider Demographics
NPI:1891315446
Name:PREFERRED REHAB LLC
Entity Type:Organization
Organization Name:PREFERRED REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-633-3151
Mailing Address - Street 1:235 E WARNER RD STE B104
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-2972
Mailing Address - Country:US
Mailing Address - Phone:480-633-3151
Mailing Address - Fax:480-383-6076
Practice Address - Street 1:235 E WARNER RD STE B104
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-2972
Practice Address - Country:US
Practice Address - Phone:480-633-3151
Practice Address - Fax:480-383-6076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty