Healthcare Provider Details

I. General information

NPI: 1891010898
Provider Name (Legal Business Name): BAKERSFIELD PHYSICAL THERAPY-FITNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 EASTON DR SUITE 131
BAKERSFIELD CA
93309-9412
US

IV. Provider business mailing address

1400 EASTON DR SUITE 131
BAKERSFIELD CA
93309-9412
US

V. Phone/Fax

Practice location:
  • Phone: 661-616-0888
  • Fax: 661-616-0889
Mailing address:
  • Phone: 661-616-0888
  • Fax: 661-616-0889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number117752
License Number StateCA

VIII. Authorized Official

Name: MRS. ZEINA MORELAND
Title or Position: CEO
Credential: PT, DPT
Phone: 661-616-0888