Provider Demographics
NPI:1720161581
Name:INTEGRATED REHABILITATION SERVICES, INC
Entity Type:Organization
Organization Name:INTEGRATED REHABILITATION SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORNELIUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-539-5351
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:1230 RTE. 16
Mailing Address - City:OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03864-0297
Mailing Address - Country:US
Mailing Address - Phone:603-539-5351
Mailing Address - Fax:603-539-3531
Practice Address - Street 1:1230 ROUTE 16
Practice Address - Street 2:HODSDON FARM BUILDING
Practice Address - City:OSSIPEE
Practice Address - State:NH
Practice Address - Zip Code:03864
Practice Address - Country:US
Practice Address - Phone:603-539-5351
Practice Address - Fax:603-539-3531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty