Healthcare Provider Details

I. General information

NPI: 1801946264
Provider Name (Legal Business Name): OPTIMAL REHAB ABILITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 N ACACIA AVE
REEDLEY CA
93654-2102
US

IV. Provider business mailing address

1433 N ACACIA AVE
REEDLEY CA
93654-2102
US

V. Phone/Fax

Practice location:
  • Phone: 559-638-4034
  • Fax: 559-638-4061
Mailing address:
  • Phone: 559-638-4034
  • Fax: 559-638-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT12805
License Number StateCA

VIII. Authorized Official

Name: FRED MAH
Title or Position: V.P.
Credential: OT
Phone: 559-261-4100