Organization
INDEPENDENT REHABILITATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL THEODORE HANSON III (CHIEF EXECUTIVE OFFICER)
(909) 886-6286
Entity
Organization
Contact information
Practice address
2037 N D ST, SUITE 105, SAN BERNARDINO, CA 92405-3936
(909) 886-6286
(909) 886-6186
Mailing address
2037 N D ST, SUITE 105, SAN BERNARDINO, CA 92405-3936
(909) 886-6286
(909) 886-6186
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT6249
CA
Other
Enumeration date
06/20/2006
Last updated
08/22/2020
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