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General NPI Number Information
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NPI Number | 1578670873
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Entity Type | Organization
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Legal Business Name | ON THE RIGHT TRACK CORP
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 5929 KILLARNEY CIR
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City | SAN JOSE
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State | CA
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Zip | 95138-2350
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Country | US
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Telephone | 561-558-3316
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Fax |
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Provider Business Mailing Address
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Address Line | 5929 KILLARNEY CIR
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City | SAN JOSE
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State | CA
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Zip | 95138-2350
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Country | US
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Telephone | 561-558-3316
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELLEN BLOOME
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Credential | P.T.
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Telephone | 561-558-3316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 6659
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License Number State | FL
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