Provider Demographics
NPI:1124627997
Name:TACTICAL REHABILITATION INC
Entity type:Organization
Organization Name:TACTICAL REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-262-9720
Mailing Address - Street 1:PO BOX 1306
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28541-1306
Mailing Address - Country:US
Mailing Address - Phone:858-254-7395
Mailing Address - Fax:
Practice Address - Street 1:2710 S. CLEAR CREEK
Practice Address - Street 2:SUITE 110
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-6685
Practice Address - Country:US
Practice Address - Phone:858-254-7395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TACTICAL REHABILITATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-22
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier