Healthcare Provider Details

I. General information

NPI: 1194178640
Provider Name (Legal Business Name): WESTERN PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 VILLAGE LN
CHICO CA
95926-2812
US

IV. Provider business mailing address

PO BOX 493396
REDDING CA
96049-3396
US

V. Phone/Fax

Practice location:
  • Phone: 530-897-0991
  • Fax: 530-897-0997
Mailing address:
  • Phone: 530-221-9952
  • Fax: 530-221-9910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DONALD R BAAS
Title or Position: CEO/PHYSICAL THERAPIST, OWNER
Credential: PT
Phone: 530-221-9952