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General NPI Number Information
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NPI Number | 1063216307
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Entity Type | Organization
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Legal Business Name | BOUNCE BACK REHABILITATION SERVICES
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 41544 ERMA AVE
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City | FREMONT
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State | CA
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Zip | 94539-4541
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Country | US
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Telephone | 248-990-4034
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Fax |
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Provider Business Mailing Address
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Address Line | 41544 ERMA AVE
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City | FREMONT
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State | CA
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Zip | 94539-4541
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Country | US
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Telephone | 248-990-4034
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | TULSI SHAH
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Credential |
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Telephone | 248-990-4034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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