Organization
IREHAB PHYSIOTHERAPY INTERVENTION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEMAR D GERVACIO (PRESIDENT)
(818) 207-0529
Entity
Organization
Contact information
Practice address
3030 MONTROSE AVE, #109, LA CRESCENTA, CA 91214-3641
(818) 207-0529
Mailing address
3030 MONTROSE AVE, #109, LA CRESCENTA, CA 91214-3641
(818) 207-0529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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