Organization
SUMMIT REHABILITATION ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUN R HALLSTROM M.D. (PRESIDENT)
(814) 371-4524
Entity
Organization
Contact information
Practice address
89 BEAVER DR, DU BOIS, PA 15801-2425
(814) 371-4524
(814) 371-0331
Mailing address
89 BEAVER DR, DU BOIS, PA 15801-2425
(814) 371-4524
(814) 371-0331
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019058600001
—
PA
05
—
0019058600010
—
PA
01
—
CK3541
PALMETTO GBA, RAILROAD MEDICARE
PA
Enumeration date
08/31/2006
Last updated
10/06/2008
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