Provider Demographics
NPI:1144815382
Name:COMMUNITY REHAB AND PERFORMANCE
Entity type:Organization
Organization Name:COMMUNITY REHAB AND PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:KISOR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:334-209-1199
Mailing Address - Street 1:560 DEVALL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-6655
Mailing Address - Country:US
Mailing Address - Phone:334-209-1199
Mailing Address - Fax:334-209-6036
Practice Address - Street 1:560 DEVALL DR STE 201
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-6655
Practice Address - Country:US
Practice Address - Phone:334-209-1199
Practice Address - Fax:334-209-6036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty