Organization
CUSTOM REHAB BRACING AND MEDICAL SUPPLY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARCADIO RODRIGUEZ RODRIGUEZ O.T (OWNER)
(408) 660-0120
Entity
Organization
Contact information
Practice address
721 RIVER PARK DR, SAN JOSE, CA 95111-1552
(408) 660-0120
(408) 333-9632
Mailing address
721 RIVER PARK DR, SAN JOSE, CA 95111-1552
(408) 660-0120
(408) 333-9632
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
101-555617
CA
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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