Healthcare Provider Details
I. General information
NPI: 1982627949
Provider Name (Legal Business Name): REHABILITATION AND OCCUPATIONAL CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/25/2006
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1635 CREEKSIDE DR SUITE 101
FOLSOM CA
95630-3830
US
IV. Provider business mailing address
1635 CREEKSIDE DR SUITE 101
FOLSOM CA
95630-3830
US
V. Phone/Fax
- Phone: 916-983-5611
- Fax: 916-983-5615
- Phone: 916-983-5611
- Fax: 916-983-5615
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 16050 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251E1200X |
| Taxonomy | Ergonomics Physical Therapist |
| License Number | 12318 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 26357 |
| License Number State | CA |
VIII. Authorized Official
Name: MR.
MATTHEW
ALAN
SMITH
Title or Position: OWNER
Credential: PT
Phone: 916-983-5611