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General NPI Number Information
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NPI Number | 1407089428
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Entity Type | Organization
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Legal Business Name | SYNERGY REHAB SERVICES INC.
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 1580 SOUTHGATE AVE #420
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City | DALY CITY
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State | CA
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Zip | 94015-2262
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Country | US
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Telephone | 650-283-2087
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Fax | 650-991-3658
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Provider Business Mailing Address
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Address Line | 1580 SOUTHGATE AVE #420
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City | DALY CITY
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State | CA
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Zip | 94015-2262
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Country | US
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Telephone | 650-283-2087
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Fax | 650-991-3658
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE MARIE MANGIO
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Credential | OT
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Telephone | 650-283-2087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT8458
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License Number State | CA
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