Prorehab PC

NPI #1629691639 in Rolla, Missouri

Provider Information

NPI Number: 1629691639
Entity Type: Organization
Organization Name: Prorehab PC
Subpart: Yes (part of a larger organization)
Parent Organization: PROREHAB PC
Primary Specialty: Clinic/Center
Enumeration Date: May 26, 2020
Last Updated: May 26, 2020

Practice Location

Address: 603 S BISHOP AVE STE B
City: Rolla
State: Missouri
ZIP Code: 65401-4320
Phone: (573) 202-6537

Authorized Official

Name: JUANA GRANADOS
Title: CREDENTIALING MANANGER
Phone: (630) 575-1980

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X
Occupational Therapist	225X00000X
Clinic/Center	261Q00000X	Primary

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