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General NPI Number Information
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NPI Number | 1215476312
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Entity Type | Organization
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Legal Business Name | SPECIALIZED ORTHOPEDIC SOLUTIONS INC
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 9259 ETON AVE
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City | CHATSWORTH
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State | CA
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Zip | 91311-5808
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Country | US
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Telephone | 818-280-3147
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Fax | 323-978-2479
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Provider Business Mailing Address
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Address Line | 14431 VENTURA BLVD SUITE 290
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2606
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Country | US
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Telephone | 818-280-3147
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Fax | 323-978-2479
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. JEFFREY VONDERHAAR
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Credential |
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Telephone | 818-280-3147
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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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