Provider Demographics
NPI:1558186866
Name:NEURO REHAB MD LLC
Entity type:Organization
Organization Name:NEURO REHAB MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-392-7936
Mailing Address - Street 1:PO BOX 1554
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-6554
Mailing Address - Country:US
Mailing Address - Phone:614-328-0099
Mailing Address - Fax:614-864-9709
Practice Address - Street 1:1437 HAVERHILL CT
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-4903
Practice Address - Country:US
Practice Address - Phone:216-392-7936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty