Provider Demographics
NPI:1447075650
Name:NECESITO SPORTS THERAPY
Entity type:Organization
Organization Name:NECESITO SPORTS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IAN CEDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:NECESITO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, ST, PT
Authorized Official - Phone:909-993-3132
Mailing Address - Street 1:1261 N SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-3628
Mailing Address - Country:US
Mailing Address - Phone:909-993-3132
Mailing Address - Fax:
Practice Address - Street 1:870 N DIAMOND BAR BLVD
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1039
Practice Address - Country:US
Practice Address - Phone:909-993-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty