Organization
CENTER FOR INDEPENDENT REHABILITATIVE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDDIE G ROGERS CPO (PRESIDENT)
(209) 549-1000
Entity
Organization
Contact information
Practice address
1508 COFFEE RD STE A, MODESTO, CA 95355
(209) 549-1000
(209) 549-1016
Mailing address
1508 COFFEE RD STE A, MODESTO, CA 95355-3181
(209) 549-1000
(209) 549-1016
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GFC000220
—
CA
Enumeration date
07/03/2006
Last updated
06/14/2018
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