Provider Demographics
NPI:1043833346
Name:RECHARGE PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:RECHARGE PHYSICAL THERAPY, INC
Other - Org Name:RECHARGE THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:562-285-3449
Mailing Address - Street 1:5175 E PACIFIC COAST HWY STE 403
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3313
Mailing Address - Country:US
Mailing Address - Phone:562-285-3449
Mailing Address - Fax:424-210-5112
Practice Address - Street 1:5175 E PACIFIC COAST HWY STE 403
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3313
Practice Address - Country:US
Practice Address - Phone:562-285-3449
Practice Address - Fax:424-210-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy