Provider Demographics
NPI:1285277392
Name:DYNAMIC REHAB SERVICES LLC
Entity type:Organization
Organization Name:DYNAMIC REHAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FRANICS
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L MOT
Authorized Official - Phone:561-714-7332
Mailing Address - Street 1:1899 N CONGRESS AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8215
Mailing Address - Country:US
Mailing Address - Phone:561-573-6667
Mailing Address - Fax:561-658-0215
Practice Address - Street 1:1899 N CONGRESS AVE STE 9
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8215
Practice Address - Country:US
Practice Address - Phone:561-573-6667
Practice Address - Fax:561-658-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation