Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sport & Rehab Physical Therapy Incorporated

Organization Physical Therapy Clinic/Center · NPI 1558512327

Sport & Rehab Physical Therapy Incorporated is a Physical Therapy Clinic/Center in Los Banos, California. Licensed in California. Registered with an NPI since 2008.

Licensed in
CA
In the registry since
2008

Practice location Address checks out

312 W J St
Los Banos, CA 93635-4069
Phone: (209) 827-6178
Fax: (209) 827-6179
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Clinic/Center (primary) Taxonomy 261QP2000X · Licence PT23597 (CA)

Record details

NPI number1558512327
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Scott Russell — Owner/Physical Therapist · (209) 827-6178
NPI enumeratedOctober 9, 2008
Last updated in NPPESJuly 19, 2024
Certification dateJuly 19, 2024
Mailing address312 W J St, Los Banos, CA 93635-4069