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General NPI Number Information
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NPI Number | 1902126162
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Entity Type | Organization
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Legal Business Name | SOUTHWEST REHAB SOLUTIONS
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 1463 S 4TH ST
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City | EL CENTRO
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State | CA
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Zip | 92243-4749
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Country | US
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Telephone | 760-791-6498
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Fax |
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Provider Business Mailing Address
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Address Line | 4217 OLIVER CT 6
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City | SAN DIEGO
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State | CA
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Zip | 92109-3955
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Country | US
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Telephone | 760-791-6498
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REHAB
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Name | MS. LUDE REGINE RICARD
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Credential | PT
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Telephone | 619-621-9215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT33814
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License Number State | CA
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