MEDICARE: LAFAYETTE PHYSICAL THERAPY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251E1300X	Clinical Electrophysiology Physical Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1346614963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAFAYETTE PHYSICAL THERAPY, INC.

Provider Business Mailing Address
First Line	:	380 CIVIC DR STE 100
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-1946
Country	:	US
Telephone Number	:	925-284-3840
Fax Number	:	855-814-4495

Provider Business Practice Location Address
First Line	:	380 CIVIC DR STE 100
Second Line	:
City	:	PLEASANT HILL
State	:	CA
Zip	:	94523-1946
Country	:	US
Telephone Number	:	925-284-3840
Fax Number	:	855-814-4495

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JILL HANAE RAMSEY
Credential	:
Telephone Number	:	925-284-6150

Provider Enumeration Date	:	11/19/2015
Last Update Date	:	01/31/2023

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