| Organization Name: | PENINSULA REHABILITATION AND SPORTS MEDICINE, INC. |
| NPI Number: | 1417115049 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLEY K. ROGAN (VICE PRESIDENT) |
| Mailing Address: | 18958 Coastal Hwy Ste A Rehoboth Beach |
| State: | DE US |
| Postal Code: | 199716196 |
| Phone Number: | 3026459797 |
| Fax Number: | 3026450411 |
| NPI Enumeration Date: | 05/30/2008 |
| NPI Last Update Date: | 05/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | J1-0002288 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DE |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |