Organization
PACIFIC REHAB, INC.
Active
Other names
Advance Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JOHANNA PAZ MAMARIL RPT (PRESIDENT)
(909) 835-0638
Entity
Organization
Contact information
Practice address
101 E REDLANDS BLVD, SUITE 245, REDLANDS, CA 92373-4775
(909) 835-0638
(760) 416-9852
Mailing address
PO BOX 12112, SAN BERNARDINO, CA 92423-2112
(909) 835-0638
(760) 416-9852
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT 29464
CA
Other
Enumeration date
05/11/2006
Last updated
08/22/2020
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