Provider Demographics
NPI:1447423181
Name:MOBILE REHAB, L.L.C.
Entity type:Organization
Organization Name:MOBILE REHAB, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-519-0360
Mailing Address - Street 1:16415 WILSON FARM DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-4558
Mailing Address - Country:US
Mailing Address - Phone:636-519-0360
Mailing Address - Fax:636-519-0370
Practice Address - Street 1:16415 WILSON FARM DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63005-4558
Practice Address - Country:US
Practice Address - Phone:636-519-0360
Practice Address - Fax:636-519-0370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty