# POWERBACK REHABILITATION LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Powerback Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093498610
- **Authorized official:** CARL ANTHONY SHROM (CEO)
- **Authorized official phone:** (215) 896-0422

## Contact information

- **Practice address:** 1515 KINGSRIDGE DR, OKLAHOMA CITY, OK 73170-4475
- **Practice address phone:** (405) 676-7274
- **Mailing address:** 101 E STATE ST, KENNETT SQUARE, PA 19348-3109
- **Mailing address phone:** (800) 728-8808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2023
- **Last updated:** 08/10/2023