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General NPI Number Information
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NPI Number | 1063489276
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Entity Type | Organization
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Legal Business Name | NOVACARE REHABILITATION
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6335 N FRESNO ST SUITE 108
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City | FRESNO
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State | CA
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Zip | 93710-5272
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Country | US
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Telephone | 559-435-6735
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Fax | 559-435-5793
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Provider Business Mailing Address
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Address Line | 6335 N FRESNO ST SUITE 108
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City | FRESNO
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State | CA
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Zip | 93710-5272
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Country | US
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Telephone | 559-435-6735
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Fax | 559-435-5793
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MRS. MELISSA S OLSON
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Credential | M.P.T.
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Telephone | 559-435-6735
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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 | 30136
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License Number State | CA
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