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General NPI Number Information
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NPI Number | 1033917232
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Entity Type | Organization
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Legal Business Name | TACTICAL REHABILITATION INC
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 701 PALOMAR AIRPORT RD STE 300
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City | CARLSBAD
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State | CA
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Zip | 92011-1028
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Country | US
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Telephone | 442-264-1870
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Fax | 910-210-0791
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Provider Business Mailing Address
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Address Line | 2040 WILMINGTON HWY STE A
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City | JACKSONVILLE
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State | NC
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Zip | 28540-3191
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Country | US
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Telephone | 910-210-0790
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Fax | 910-210-0791
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | KATRINA GARCIA
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Credential |
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Telephone | 772-275-4862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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