Provider First Line Business Practice Location Address:
751 SOUTH BASCOM AVENUE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-885-2100
Provider Business Practice Location Address Fax Number:
408-885-2028
Provider Enumeration Date:
10/13/2008