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General NPI Number Information
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NPI Number | 1609586494
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Entity Type | Organization
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Legal Business Name | MOTION CENTRIC REHABILITATION LLC
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 260 S SUNNYVALE AVE STE 2
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City | SUNNYVALE
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State | CA
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Zip | 94086-6273
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Country | US
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Telephone | 408-329-9604
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Fax | 408-262-1321
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Provider Business Mailing Address
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Address Line | 687 S DANIEL WAY
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City | SAN JOSE
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State | CA
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Zip | 95128-3121
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Country | US
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Telephone | 336-875-2511
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | KHUSHBOO SHAH
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Credential | PT
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Telephone | 336-875-2511
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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 |
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License Number State |
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