Sport Rehab, Inc.

NPI #1396794970 in Rolla, Missouri

Provider Information

NPI Number: 1396794970
Entity Type: Organization
Organization Name: Sport Rehab, Inc.
Primary Specialty: Physical Therapist
Enumeration Date: May 9, 2006
Last Updated: Aug 9, 2010

Practice Location

Address: 906 N CEDAR ST
City: Rolla
State: Missouri
ZIP Code: 65401-3350
Phone: (573) 368-0999

Authorized Official

Name: MRS. MARIKAY L PORTELL, MSPT/ATC
Title: VICE PRESIDENT
Phone: (573) 368-0999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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