Healthcare Provider Details

I. General information

NPI: 1578582763
Provider Name (Legal Business Name): KRPATA SPORTS THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26617 CARMEL CENTER PL
CARMEL CA
93923-8655
US

IV. Provider business mailing address

26617 CARMEL CENTER PL
CARMEL CA
93923-8655
US

V. Phone/Fax

Practice location:
  • Phone: 831-622-0599
  • Fax: 831-622-7599
Mailing address:
  • Phone: 831-622-0599
  • Fax: 831-622-7599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES E KRPATA
Title or Position: OWNER/MANAGER
Credential: PT
Phone: 831-622-0599