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General NPI Number Information
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NPI Number | 1962557942
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Entity Type | Organization
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Legal Business Name | AGENCY REHAB, INC.
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3311 E WILLOW ST
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City | LONG BEACH
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State | CA
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Zip | 90806-2310
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Country | US
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Telephone | 562-426-2051
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Fax |
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Provider Business Mailing Address
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Address Line | 3248 E WILLOW ST
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City | SIGNAL HILL
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State | CA
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Zip | 90755-2309
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Country | US
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Telephone | 562-426-2051
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KEVIN EUGENE SMITH
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Credential |
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Telephone | 562-426-2051
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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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