Healthcare Provider Details

I. General information

NPI: 1982437919
Provider Name (Legal Business Name): HYBRID PERFORMANCE AND PHYSIOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2909 WOODGLEN DR
BAKERSFIELD CA
93311-2337
US

IV. Provider business mailing address

2909 WOODGLEN DR
BAKERSFIELD CA
93311-2337
US

V. Phone/Fax

Practice location:
  • Phone: 626-434-9677
  • Fax:
Mailing address:
  • Phone: 626-434-9677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SANDRA HARRELL
Title or Position: PT
Credential: DPT
Phone: 626-434-9677