Organization
DYLAN RC ENTERPRISES INC
Active
Organization
DYLAN RC ENTERPRISES INC
Active
Other names
PRO Rehabilitation Services
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MITERKO (CREDENTIALING)
(570) 823-7761
Entity
Organization
Contact information
Practice address
693 MAIN ST, NEW MILFORD, PA 18834-7200
(570) 465-2027
(570) 465-2028
Mailing address
1086 HIGHWAY 315 BLVD, WILKES BARRE, PA 18702-7012
(570) 823-7761
(570) 822-8033
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
396759
MEDICARE
PA
Enumeration date
02/11/2021
Last updated
02/11/2021
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