Provider Demographics
NPI:1720112931
Name:PHYSIOTHERAPY ASSOCIATES HOME REHABILITATION, LLC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES HOME REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL BUSINESS MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-556-5932
Mailing Address - Street 1:610 S MAPLE AVE
Mailing Address - Street 2:SUITE 3400
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1091
Mailing Address - Country:US
Mailing Address - Phone:708-358-9911
Mailing Address - Fax:708-358-9922
Practice Address - Street 1:610 S MAPLE AVE
Practice Address - Street 2:SUITE 3400
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:708-358-9911
Practice Address - Fax:708-358-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health