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
1515 KINGSRIDGE DR, OKLAHOMA CITY, OK 73170-4475
(405) 676-7274
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(800) 728-8808
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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