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
1050 FOUNTAIN LAKES DR, O FALLON, IL 62269-2595
(779) 713-0903
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(800) 728-8808
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
04/03/2025
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