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NPI Code Detail

MEDICARE: WSSH POWERBACK REHABILITATION SERVICES, LLC

MEDICARE: WSSH POWERBACK REHABILITATION SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1790619724
Entity Type Code : Organization
Provider Name (Legal Business Name) : WSSH POWERBACK REHABILITATION SERVICES, LLC
Provider Business Mailing Address
First Line : 9526 W PICO BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90035-1202
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 MAPLEWOOD DR
Second Line :
City : BRIDGEPORT
State : WV
Zip : 26330-9115
Country : US
Telephone Number : 304-933-3338
Fax Number :
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : AVROHOM TRESS
Credential :
Telephone Number : 323-928-9445
Provider Enumeration Date : 06/12/2026
Last Update Date : 06/12/2026

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Directions to “WSSH POWERBACK REHABILITATION SERVICES, LLC ” Practice Location

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