Organization
FUN ZONE KIDS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANISHA ANTONY OTR/L (CEO)
(716) 464-0558
Entity
Organization
Contact information
Practice address
6489 CAMDEN AVE, SAN JOSE, CA 95120-2849
(716) 464-0558
Mailing address
6424 MONTEGO CT, SAN JOSE, CA 95120-5101
(716) 464-0558
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/31/2022
Last updated
08/31/2022
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