Healthcare Provider Details

I. General information

NPI: 1699050260
Provider Name (Legal Business Name): PTP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 05/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W VALLEY BLVD
ALHAMBRA CA
91803-3338
US

IV. Provider business mailing address

1814 W ALAMEDA AVE
BURBANK CA
91506-2929
US

V. Phone/Fax

Practice location:
  • Phone: 626-289-2268
  • Fax: 626-289-3499
Mailing address:
  • Phone: 706-306-3641
  • Fax: 818-861-7348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: TAMI PEAVY
Title or Position: ONWER
Credential: MPT
Phone: 706-306-3641