Organization
CENTER FOR INDEPENDENT REHABILITATIVE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE G ROGERS CPO (PRESIDENT)
(209) 845-8231
Entity
Organization
Contact information
Practice address
1745 KETTLEMAN LANE, SUITE A, LODI, CA 95242-9287
(209) 333-1148
(209) 333-0624
Mailing address
693 HI TECH PARKWAY, OAKDALE, CA 95361
(209) 845-8231
(209) 845-2883
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/06/2006
Last updated
02/05/2013
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