Organization Name: | REBOUND FITNESS INC |
NPI Number: | 1023310711 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREGORY CADICHON (OWNER) |
Mailing Address: | 246 E. Janata Blvd Suite 135 Lombard |
State: | IL US |
Postal Code: | 60148 |
Phone Number: | 6303766096 |
Fax Number: | |
NPI Enumeration Date: | 12/01/2010 |
NPI Last Update Date: | 08/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 070.018154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |