Organization
POWERBACK REHABILITATION LLC
Active
Other names
Powerback Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
IAN OPPEL (COO)
(980) 254-7007
Entity
Organization
Contact information
Practice address
1401 N HIGH ST, C/O THE VILLAGE AT WOOD'S EDGE, FRANKLIN, VA 23851-1244
(757) 516-8149
Mailing address
101 E STATE ST, C/O AMY NUNEMAKER, KENNETT SQUARE, PA 19348-3109
(610) 925-4560
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4978129
—
VA
Enumeration date
12/23/2005
Last updated
04/03/2025
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