Basic Information
| Provider Information | |||||||||
| NPI: | 1497985048 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PINION REHABILITATION, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1775 BROWNING WAY STE 203 | ||||||||
| Address2: | |||||||||
| City: | ELKO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 898018340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757384494 | ||||||||
| FaxNumber: | 7757773192 | ||||||||
| Practice Location | |||||||||
| Address1: | 1775 BROWNING WAY STE 203 | ||||||||
| Address2: | |||||||||
| City: | ELKO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 898018340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757384494 | ||||||||
| FaxNumber: | 7757773192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2009 | ||||||||
| LastUpdateDate: | 04/20/2010 | ||||||||
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| AuthorizedOfficialLastName: | WALDRON | ||||||||
| AuthorizedOfficialFirstName: | GLEN | ||||||||
| AuthorizedOfficialMiddleName: | NEAL | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 7757384494 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT, MSPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2233 | NV | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225X00000X | 0693 | NV | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225100000X | 1794 | NV | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 1609838879 | 01 | NV | NPI | OTHER | 1992765960 | 01 | NV | NPI | OTHER | 1346478914 | 01 | NV | NPI | OTHER |