Organization
PHYSIOSPORT: PERFORMANCE AND PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHMOUD DAHER DPT (CEO/PRESIDENT)
(209) 481-7336
Entity
Organization
Contact information
Practice address
4929 FRANCO AVE, STOCKTON, CA 95212-1909
(209) 481-7336
Mailing address
4929 FRANCO AVE, STOCKTON, CA 95212-1909
(209) 481-7336
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/27/2020
Last updated
12/28/2020
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