Provider Demographics
NPI:1780205955
Name:MY REHAB CONNECTION
Entity Type:Organization
Organization Name:MY REHAB CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:252-258-2136
Mailing Address - Street 1:350 22ND AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-2154
Mailing Address - Country:US
Mailing Address - Phone:252-258-2136
Mailing Address - Fax:
Practice Address - Street 1:350 22ND AVE APT 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-2154
Practice Address - Country:US
Practice Address - Phone:252-258-2136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy