Healthcare Provider Details

I. General information

NPI: 1609587310
Provider Name (Legal Business Name): FMRC HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N GLENOAKS BLVD STE 200
BURBANK CA
91502-1118
US

IV. Provider business mailing address

303 N GLENOAKS BLVD STE 200
BURBANK CA
91502-1118
US

V. Phone/Fax

Practice location:
  • Phone: 323-229-6025
  • Fax:
Mailing address:
  • Phone: 323-229-6025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: FUSHIA CROOMS
Title or Position: OWNER
Credential:
Phone: 323-229-6025