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NPI Code Detail

MEDICARE: MR. EDWIN JACOB STROMAN III P.T., A.T.C., C.S.C.

MEDICARE: MR. EDWIN JACOB STROMAN III P.T., A.T.C., C.S.C.
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
1225100000XPhysical TherapistCA

General Provider Information

NPI Number : 1528175031
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDWIN JACOB STROMAN III P.T., A.T.C., C.S.C.
Provider Business Mailing Address
First Line : 2490 S MAIN ST
Second Line :
City : RED BLUFF
State : CA
Zip : 96080-4337
Country : US
Telephone Number : 530-529-3636
Fax Number : 530-529-2241
Provider Business Practice Location Address
First Line : 2490 S MAIN ST
Second Line :
City : RED BLUFF
State : CA
Zip : 96080-4337
Country : US
Telephone Number : 530-529-3636
Fax Number : 530-529-2241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2006
Last Update Date : 07/08/2007

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