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General NPI Number Information
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NPI Number | 1316057771
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Entity Type | Organization
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Legal Business Name | OPTIMUM BALANCE & REHABILITATION
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 857 CASS ST SUITE A
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City | MONTEREY
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State | CA
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Zip | 93940-2919
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Country | US
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Telephone | 831-644-0450
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Fax | 831-644-0466
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Provider Business Mailing Address
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Address Line | 857 CASS ST SUITE A
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City | MONTEREY
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State | CA
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Zip | 93940-2919
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Country | US
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Telephone | 831-644-0450
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Fax | 831-644-0466
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Authorized Official
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Title or Position | OWNER
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Name | MS. LYNN M HERBERT
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Credential | PT
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Telephone | 831-644-0450
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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 | PT16302
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License Number State | CA
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