Provider Demographics
NPI:1013186113
Name:REHABILITATIVE ASSOCIATES
Entity type:Organization
Organization Name:REHABILITATIVE ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TIELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-392-8811
Mailing Address - Street 1:812 COSHOCTON AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1947
Mailing Address - Country:US
Mailing Address - Phone:740-392-8811
Mailing Address - Fax:
Practice Address - Street 1:17809 ROUTE 31
Practice Address - Street 2:MILL VALLEY PLAZA 9
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040
Practice Address - Country:US
Practice Address - Phone:740-392-8811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty