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Organization
PREMERE REHAB LLC
Active
Organization
PREMERE REHAB LLC
Active
Other names
Infinity Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY MCCOY (CREDENTIALING SPECIALIST)
(971) 224-2841
Entity
Organization
Contact information
Practice address
380 BRANHAM LN, SAN JOSE, CA 95136-4301
(408) 972-1400
Mailing address
8100 SW NYBERG ST STE 200, TUALATIN, OR 97062-8437
(503) 570-3665
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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