Organization
CREATIVE REHAB TECHNOLOGY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL STEPHEN PROTZMAN (CHIEF OPERATIONS OFFICER)
(619) 616-2649
Entity
Organization
Contact information
Practice address
320 TROUSDALE DR, UNIT B, CHULA VISTA, CA 91910-1069
(619) 616-2649
(619) 427-0500
Mailing address
320 TROUSDALE DR, UNIT B, CHULA VISTA, CA 91910-1069
(619) 616-2649
(877) 220-8272
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
103561
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME02752G
—
CA
Enumeration date
06/26/2006
Last updated
12/01/2010
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