Provider Demographics
NPI:1699969964
Name:REHAB 1 UNION
Entity type:Organization
Organization Name:REHAB 1 UNION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:636-938-4065
Mailing Address - Street 1:70 E NORTH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-1205
Mailing Address - Country:US
Mailing Address - Phone:636-938-4065
Mailing Address - Fax:636-938-4067
Practice Address - Street 1:1780 OLD HWY 50 E
Practice Address - Street 2:SUITE 109
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-3330
Practice Address - Country:US
Practice Address - Phone:636-583-7733
Practice Address - Fax:636-583-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001005492261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy