Healthcare Provider Details

I. General information

NPI: 1710113501
Provider Name (Legal Business Name): NEETU RISHIRAJ ATC, PHD CANDIDATE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2009
Last Update Date: 06/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ACTIN HEALTH AND REHABILITATION INC. 5767 OAK STREET
VANCOUVER BRITISH COLUMBIA
V6M2V7
CA

IV. Provider business mailing address

ACTIN HEALTH AND REHABILITATION INC. 5767 OAK STREET
VANCOUVER BRITISH COLUMBIA
V6M2V7
CA

V. Phone/Fax

Practice location:
  • Phone: 16042443614
  • Fax: 16042630477
Mailing address:
  • Phone: 16042443614
  • Fax: 16042630477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: