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General NPI Number Information
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NPI Number | 1407162241
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Entity Type | Organization
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Legal Business Name | INNOVATION PHYSICAL THERAPY AND REHAB CENTER, INC.
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 08/30/2010
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Provider Practice Location Address
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Address Line | 8227 SANTA INEZ WAY
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City | BUENA PARK
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State | CA
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Zip | 90620-3158
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Country | US
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Telephone | 714-496-1459
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Fax |
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Provider Business Mailing Address
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Address Line | 8227 SANTA INEZ WAY
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City | BUENA PARK
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State | CA
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Zip | 90620-3158
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Country | US
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Telephone | 714-496-1459
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEFF D SALES
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Credential | RPT
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Telephone | 714-496-1459
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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