Provider Demographics
NPI:1134423189
Name:ADVANTAGE REHAB, INC.
Entity type:Organization
Organization Name:ADVANTAGE REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:HAYMAN
Authorized Official - Last Name:SCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:443-786-0750
Mailing Address - Street 1:25324 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:MD
Mailing Address - Zip Code:21639
Mailing Address - Country:US
Mailing Address - Phone:410-479-0470
Mailing Address - Fax:410-479-0526
Practice Address - Street 1:103 S. 7TH STREET
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629
Practice Address - Country:US
Practice Address - Phone:410-479-0470
Practice Address - Fax:410-479-0526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty