| Organization Name: | JEAN L. OGBURN |
| NPI Number: | 1659433753 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEAN L. OGBURN (OWNER-ADMINISTRATOR) |
| Mailing Address: | 245 Tom Bell Rd C Murphys |
| State: | CA US |
| Postal Code: | 952479585 |
| Phone Number: | 2097280744 |
| Fax Number: | 2097280125 |
| NPI Enumeration Date: | 12/14/2006 |
| NPI Last Update Date: | 11/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | 2494 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |