Provider Demographics
NPI:1295153823
Name:PHYSICAL RESOLUTION HOME BASED REHABILITATION SERVICES INC
Entity type:Organization
Organization Name:PHYSICAL RESOLUTION HOME BASED REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-424-1733
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-0001
Mailing Address - Country:US
Mailing Address - Phone:563-424-1733
Mailing Address - Fax:563-424-1734
Practice Address - Street 1:3841 MANCHESTER DR
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1935
Practice Address - Country:US
Practice Address - Phone:563-424-1733
Practice Address - Fax:563-424-1734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty