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General NPI Number Information
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NPI Number | 1841461118
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Entity Type | Organization
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Legal Business Name | ADVANCED PT & REHAB
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 18531 ROSCOE BLVD STE 215A
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5462
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Country | US
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Telephone | 818-886-4315
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Fax | 818-886-4316
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Provider Business Mailing Address
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Address Line | 18531 ROSCOE BLVD STE 215A
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5462
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Country | US
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Telephone | 818-886-4315
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Fax | 818-886-4316
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Authorized Official
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Title or Position | MANAGER
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Name | NICOLE SUAREZ
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Credential |
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Telephone | 818-886-4315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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