Organization
MODERN REHAB
Active
Organization
MODERN REHAB
Active
Parent organization
REHABAUTHORITY LLC MBR
Organization subpart
Yes
Provider details
NPI number
Legal business name
REHABAUTHORITY LLC MBR
Authorized official
KEVIN HULSEY DPT (PRESIDENT, CEO)
(208) 288-1155
Entity
Organization
Contact information
Practice address
745 S PROGRESS AVE, MERIDIAN, ID 83642-5619
(208) 895-0309
(208) 895-0311
Mailing address
1560 S CAROL ST, MERIDIAN, ID 83646-1839
(208) 288-1155
(208) 288-0424
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2949
ID
Other
Enumeration date
07/09/2013
Last updated
09/18/2013
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