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General NPI Number Information
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NPI Number | 1730013269
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Entity Type | Organization
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Legal Business Name | WSSH POWERBACK REHABILITATION SERVICES, LLC
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 5871 HARBOUR VIEW BLVD
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City | SUFFOLK
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State | VA
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Zip | 23435-2794
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Country | US
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Telephone | 757-819-5997
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Fax |
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Provider Business Mailing Address
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Address Line | 9526 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-1202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | AVROHOM TRESS
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Credential |
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Telephone | 323-928-9445
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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 |
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License Number State |
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