MEDICARE: PRECISION PHYSICAL THERAPY & FITNESS

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	261QP2000X	Physical Therapy Clinic/Center	PT20895	CA

General Provider Information

NPI Number	:	1841437449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION PHYSICAL THERAPY & FITNESS

Provider Business Mailing Address
First Line	:	9000 SOQUEL AVE
Second Line	:	SUITE 103
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2097
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 SOQUEL AVE
Second Line	:	SUITE 103
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2097
Country	:	US
Telephone Number	:	831-464-8200
Fax Number	:

Authorized Official
Title or Position	:	DPT
Name	:	JAMES VEGHER
Credential	:
Telephone Number	:	831-464-8200

Provider Enumeration Date	:	01/19/2009
Last Update Date	:	01/19/2009

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