Provider Demographics
NPI:1740436047
Name:FREEDOM REHABILITATION CENTERS
Entity type:Organization
Organization Name:FREEDOM REHABILITATION CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:D
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:724-779-1277
Mailing Address - Street 1:PO BOX 14397
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-7397
Mailing Address - Country:US
Mailing Address - Phone:330-758-2775
Mailing Address - Fax:330-758-2787
Practice Address - Street 1:20630 ROUTE 19 STE 102
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6001
Practice Address - Country:US
Practice Address - Phone:724-779-1277
Practice Address - Fax:724-779-1280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017392225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty