Provider Demographics
NPI:1235764473
Name:TACTICAL REHABILITATION INC
Entity type:Organization
Organization Name:TACTICAL REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-262-9720
Mailing Address - Street 1:PO BOX 1306
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28541-1306
Mailing Address - Country:US
Mailing Address - Phone:423-262-9720
Mailing Address - Fax:
Practice Address - Street 1:15110 UNION AVE SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-2093
Practice Address - Country:US
Practice Address - Phone:360-406-4891
Practice Address - Fax:910-210-0791
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TACTICAL REHABILITATION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-09
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies