Organization
OMEGA SPORTS REHABILITATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JACK (DIRECTOR OWNER)
(408) 358-3631
Entity
Organization
Contact information
Practice address
14901 NATIONAL AVE, STE 102, LOS GATOS, CA 95032
(408) 358-3631
(408) 358-4537
Mailing address
14901 NATIONAL AVE, STE 102, LOS GATOS, CA 95032
(408) 358-3631
(408) 358-4537
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
239059200
DEPT OF LABOR WORKERS COM
—
Enumeration date
03/14/2007
Last updated
07/21/2022
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