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Organization
CUSTOM REHAB BRACING AND MEDICAL SUPPLY,LLC
Active
Organization
CUSTOM REHAB BRACING AND MEDICAL SUPPLY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARCADIO RODRIGUEZ RODRIGUEZ O.T (OWNER)
(408) 660-0120
Entity
Organization
Contact information
Practice address
721 RIVER PARK DR, SAN JOSE, CA 95111-1552
(408) 660-0120
(408) 333-9632
Mailing address
721 RIVER PARK DR, SAN JOSE, CA 95111-1552
(408) 660-0120
(408) 333-9632
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
101-555617
CA
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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