Provider Demographics
NPI:1528833928
Name:JENNY REHAB CARE PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:JENNY REHAB CARE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENY
Authorized Official - Middle Name:
Authorized Official - Last Name:GADIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:323-880-9938
Mailing Address - Street 1:114 OLIVE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4667
Mailing Address - Country:US
Mailing Address - Phone:323-880-9938
Mailing Address - Fax:
Practice Address - Street 1:114 OLIVE ST APT 3
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4667
Practice Address - Country:US
Practice Address - Phone:323-880-9938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty