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General NPI Number Information
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NPI Number | 1396559316
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Entity Type | Organization
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Legal Business Name | OSO PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1726 CLEMENT AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-1205
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Country | US
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Telephone | 510-915-1448
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Fax |
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Provider Business Mailing Address
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Address Line | 222 LAGUNARIA LN
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City | ALAMEDA
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State | CA
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Zip | 94502-6702
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Country | US
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Telephone | 616-617-6325
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Fax |
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Authorized Official
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Title or Position | COO
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Name | BENJAMIN THOMAS FEDEWA
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Credential | PT, DPT
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Telephone | 616-617-6325
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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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