Provider Demographics
NPI:1255929444
Name:ORANGE GROVE PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:ORANGE GROVE PHYSICAL THERAPY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMPUR
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT
Authorized Official - Phone:909-255-0611
Mailing Address - Street 1:1401 CAMBRIA CT
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-2794
Mailing Address - Country:US
Mailing Address - Phone:216-262-4708
Mailing Address - Fax:
Practice Address - Street 1:415 E PALM AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6135
Practice Address - Country:US
Practice Address - Phone:909-255-0611
Practice Address - Fax:909-789-1317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty