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General NPI Number Information
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NPI Number | 1598233587
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Entity Type | Organization
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Legal Business Name | ABILITIES FOR KIDS, INC.
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 522 E MAIN ST
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City | SANTA MARIA
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State | CA
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Zip | 93454-4504
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Country | US
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Telephone | 805-925-1107
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1501
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City | SANTA MARIA
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State | CA
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Zip | 93456-1501
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Country | US
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Telephone | 805-925-1107
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CONNIE CHAN
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Credential | DO
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Telephone | 805-925-1107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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