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General NPI Number Information
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NPI Number | 1265250187
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Entity Type | Organization
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Legal Business Name | BREATH OF FRESH AIR PULMONARY REHAB LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 10/13/2024
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Provider Practice Location Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 760-458-2087
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 21ST ST STE R
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City | SACRAMENTO
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State | CA
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Zip | 95811-5226
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Country | US
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Telephone | 760-458-2087
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Fax |
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Authorized Official
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Title or Position | RESPIRATORY THERAPIST
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Name | CHRISTOPHER MCGONEGAL
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Credential | RRT
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Telephone | 760-707-4506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2278P1005X
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Taxonomy Name | Pulmonary Rehabilitation Certified Respiratory Therapist
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License Number |
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License Number State |
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