# POWERBACK REHABILITATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235530833
- **Authorized official:** KELLY LOCASCIO M.A. (SPEECH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (973) 722-2015

## Contact information

- **Practice address:** 113 ROUTE 73, VOORHEES, NJ 08043-9573
- **Practice address phone:** (856) 809-3500
- **Mailing address:** 31 N MAPLE AVE, \#308, MARLTON, NJ 08053-1700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | TL-2326 | NJ | Yes |

## Other

- **Enumeration date:** 09/15/2014
- **Last updated:** 09/15/2014
