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Organization

PROREHAB, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUANA GRANADOS (CREDENTIALING MANAGER)
(630) 575-1980
Entity
Organization

Contact information

Practice address
2200 BARRETT STATION RD STE 200, BALLWIN, MO 63021-5893
(314) 238-1130
(314) 238-1132
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6250
(630) 575-7450

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
225X00000X
Occupational Therapist
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Enumeration date
05/18/2006
Last updated
06/29/2020
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