Provider Demographics
NPI:1982423661
Name:REBOUND HEALTH & PERFORMANCE
Entity type:Organization
Organization Name:REBOUND HEALTH & PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, SCS, CSCS
Authorized Official - Phone:843-618-2037
Mailing Address - Street 1:2819 BRIAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-0711
Mailing Address - Country:US
Mailing Address - Phone:843-618-2037
Mailing Address - Fax:
Practice Address - Street 1:2819 BRIAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-0711
Practice Address - Country:US
Practice Address - Phone:843-618-2037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty