Organization
SPORT & REHAB PHYSICAL THERAPY INCORPORATED
Active
Organization
SPORT & REHAB PHYSICAL THERAPY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT RUSSELL (OWNER/PHYSICAL THERAPIST)
(209) 827-6178
Entity
Organization
Contact information
Practice address
312 W J ST, LOS BANOS, CA 93635-4069
(209) 827-6178
(209) 827-6179
Mailing address
312 W J ST, LOS BANOS, CA 93635-4069
(209) 827-6178
(209) 827-6179
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT23597
CA
Other
Enumeration date
10/09/2008
Last updated
07/19/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up