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Organization
POWERBACK REHABILITATION LLC
Active
Organization
POWERBACK REHABILITATION LLC
Active
Other names
Powerback Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
CARL ANTHONY SHROM (CEO)
(215) 896-0422
Entity
Organization
Contact information
Practice address
3500 12TH ST, TILLAMOOK, OR 97141-2637
(971) 354-4267
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(800) 728-8808
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/21/2021
Last updated
03/31/2023
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