Provider Demographics
NPI:1801068523
Name:PHYSICIAN'S REHAB SERVICES OF CARLSBAD
Entity type:Organization
Organization Name:PHYSICIAN'S REHAB SERVICES OF CARLSBAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:RADHESHYAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:575-885-3370
Mailing Address - Street 1:2427 W PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3558
Mailing Address - Country:US
Mailing Address - Phone:575-885-3370
Mailing Address - Fax:575-885-1841
Practice Address - Street 1:2427 W PIERCE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3558
Practice Address - Country:US
Practice Address - Phone:575-885-3370
Practice Address - Fax:575-885-1841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM302225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty