Organization
PACIFIC REHAB, INC.
Active
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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