Prorehab PC

NPI #1972148179 in Eldon, Missouri

Provider Information

NPI Number: 1972148179
Entity Type: Organization
Organization Name: Prorehab PC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 12, 2019
Last Updated: Nov 12, 2019

Practice Location

Address: 301 S MAPLE ST
City: Eldon
State: Missouri
ZIP Code: 65026-1854
Phone: (573) 375-5944

Authorized Official

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

Specialties & Taxonomy Codes

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

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