Organization
REBOUND REHAB
Active
Organization
REBOUND REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. XANDRA TIELMAN M.S., CCC-SLP (SPEECH PATHOLOGIST)
(916) 772-2909
Entity
Organization
Contact information
Practice address
6526 LONETREE BLVD, ROCKLIN, CA 95765-5886
(916) 772-2909
(916) 772-2989
Mailing address
6526 LONETREE BLVD, ROCKLIN, CA 95765-5886
(916) 772-2909
(916) 772-2989
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
SLP9200
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP9200
CA DEPARTMENT OF CONSUMER AFFAIRS
CA
Enumeration date
12/27/2010
Last updated
12/27/2010
Update your record
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