# PROREHAB PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROREHAB PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417502246
- **Legal business name:** PROREHAB PC
- **Authorized official:** JUANA GRANADOS (CREDENTIALING MANAGER)
- **Authorized official phone:** (630) 575-1980

## Contact information

- **Practice address:** 2900 TRIMBLE RD STE 101, COLUMBIA, MO 65201-7180
- **Practice address phone:** (573) 397-7036
- **Mailing address:** 600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
- **Mailing address phone:** (630) 575-6250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/08/2019
- **Last updated:** 08/08/2019