Basic Information
| Provider Information | |||||||||
| NPI: | 1891711974 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REBOUND PHYSICAL THERAPY AT WOOD VALLEY | ||||||||
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| OtherOrganizationName: | REBOUND PHYSICAL THERAPY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2909 SW 37TH ST | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666143569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852665850 | ||||||||
| FaxNumber: | 7852660021 | ||||||||
| Practice Location | |||||||||
| Address1: | 5220 SW 17TH ST STE 130 | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666042458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852715533 | ||||||||
| FaxNumber: | 7852718818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | UNREIN | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | AD | ||||||||
| AuthorizedOfficialTelephone: | 7852715533 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PTA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 115053 | 01 | KS | BCBS | OTHER |