1235682451 NPI number — INBOX FUNCTIONAL REHAB, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235682451 NPI number — INBOX FUNCTIONAL REHAB, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INBOX FUNCTIONAL REHAB, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235682451
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2825 BURGESS LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAPLEWOOD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63143-2801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-322-7347
Provider Business Mailing Address Fax Number:
314-932-2394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1099 MILWAUKEE ST
Provider Second Line Business Practice Location Address:
240
Provider Business Practice Location Address City Name:
KIRKWOOD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63122-7356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-822-1502
Provider Business Practice Location Address Fax Number:
314-821-9889
Provider Enumeration Date:
07/25/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BRYANT
Authorized Official First Name:
TYLER
Authorized Official Middle Name:
B
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
618-322-7347

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com