Provider Demographics
NPI:1649521477
Name:REBOUND PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:REBOUND PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICARE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CADBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-499-1082
Mailing Address - Street 1:7430 N. PINNACLE PEAK RD
Mailing Address - Street 2:SUITE 138
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255
Mailing Address - Country:US
Mailing Address - Phone:480-502-4324
Mailing Address - Fax:480-502-1397
Practice Address - Street 1:7430 NORTH PINNACLE PEAK RD
Practice Address - Street 2:SUITE 138
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3630
Practice Address - Country:US
Practice Address - Phone:480-502-4324
Practice Address - Fax:480-502-1397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8719261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy