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General NPI Number Information
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NPI Number | 1598073850
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Entity Type | Organization
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Legal Business Name | KRS-PT, INC.
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 12670 STANTON AVE
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City | TUSTIN
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State | CA
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Zip | 92782-1027
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Country | US
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Telephone | 714-926-1913
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 28682
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City | ANAHEIM
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State | CA
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Zip | 92809-0156
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Country | US
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Telephone | 714-926-1913
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Fax | 866-903-8974
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. REHA CHANDRAKANT SHRIKHANDE
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Credential | MPT
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Telephone | 714-926-1913
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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 | 29649
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License Number State | CA
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