# SHINE REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093358657
- **Authorized official:** MATTHEW GRIFFIS PT (PRINCIPAL)
- **Authorized official phone:** (321) 274-2745

## Contact information

- **Practice address:** 614 N FREEMAN ST, OCEANSIDE, CA 92054-2417
- **Practice address phone:** (321) 274-2745
- **Mailing address:** 614 N FREEMAN ST, OCEANSIDE, CA 92054-2417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251G0304X | Geriatric Physical Therapist | — | NULL | Yes |
| 2251G0304X | Geriatric Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2019
- **Last updated:** 02/12/2020