| Organization Name: | POCATELLO REHABILITATION PA |
| NPI Number: | 1528143864 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN S. HILL (PRESIDENT) |
| Mailing Address: | 500 S 11th Ave Ste 201 Pocatello |
| State: | ID US |
| Postal Code: | 832014878 |
| Phone Number: | 2082341984 |
| Fax Number: | 2082341987 |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | M5852 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |