Provider Demographics
NPI:1013241447
Name:DYNAMIC REHAB SOLUTIONS
Entity Type:Organization
Organization Name:DYNAMIC REHAB SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TUKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-796-9445
Mailing Address - Street 1:4400 LEWIS RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2544
Mailing Address - Country:US
Mailing Address - Phone:717-972-0391
Mailing Address - Fax:717-972-0389
Practice Address - Street 1:4400 LEWIS RD
Practice Address - Street 2:SUITE E
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2544
Practice Address - Country:US
Practice Address - Phone:717-972-0391
Practice Address - Fax:717-972-0389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6354190001Medicare NSC