Provider Demographics
NPI:1508021288
Name:AANSTAD REHAB & WELLNESS, LLC
Entity Type:Organization
Organization Name:AANSTAD REHAB & WELLNESS, LLC
Other - Org Name:AANSTAD WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-397-5757
Mailing Address - Street 1:PO BOX 66141
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-0141
Mailing Address - Country:US
Mailing Address - Phone:310-397-5757
Mailing Address - Fax:
Practice Address - Street 1:11961 VENICE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-3900
Practice Address - Country:US
Practice Address - Phone:310-391-5757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty