Organization
POWERBACK REHABILITATION LLC
Active
Other names
Genesis Rehabilitation Services
Organization subpart
No
Provider details
NPI number
Authorized official
CARL ANTHONY SHROM (CEO)
(215) 896-0422
Entity
Organization
Contact information
Practice address
1234 S PARK BLVD, FREEPORT, IL 61032-4602
(815) 616-5952
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4560
(610) 347-4147
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/10/2018
Last updated
02/27/2023
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