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
13650 HEATHCOTE BLVD, GAINESVILLE, VA 20155-3344
(571) 486-1095
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4560
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2018
Last updated
03/02/2023
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