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General NPI Number Information
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NPI Number | 1154132090
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Entity Type | Organization
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Legal Business Name | REHABMARK THERAPY AND WELLNESS, A PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 9631 MONTE VISTA AVE
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City | MONTCLAIR
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State | CA
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Zip | 91763-2233
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Country | US
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Telephone | 909-358-1699
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Fax |
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Provider Business Mailing Address
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Address Line | 2934 E GARVEY AVE S STE 250
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City | WEST COVINA
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State | CA
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Zip | 91791-2186
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Country | US
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Telephone | 909-358-1699
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. MARK ANTHONY PALACIOS
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Credential | PT
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Telephone | 909-802-5824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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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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