Provider Demographics
NPI:1588964241
Name:ALL 4 ONE REHABILITATION
Entity type:Organization
Organization Name:ALL 4 ONE REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:MCGAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:270-554-3135
Mailing Address - Street 1:2500 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-5529
Mailing Address - Country:US
Mailing Address - Phone:270-554-3135
Mailing Address - Fax:270-554-3136
Practice Address - Street 1:2500 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-5529
Practice Address - Country:US
Practice Address - Phone:270-554-3135
Practice Address - Fax:270-554-3136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2256261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)