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Organization
NEUROSPORT REHABILITATION ASSOCIATES
Active
Organization
NEUROSPORT REHABILITATION ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY ANN TOTH (SUPERVISOR)
(510) 608-3614
Entity
Organization
Contact information
Practice address
3905 BEACON AVE, FREMONT, CA 94538-1405
(510) 792-3555
Mailing address
2296 COUNTRY DR, FREMONT, CA 94536-5315
(510) 797-9299
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ19979Z
BLUE SHIELD ID
CA
Enumeration date
10/21/2005
Last updated
08/22/2020
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