Healthcare Provider Details

I. General information

NPI: 1861422818
Provider Name (Legal Business Name): EUREKA PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 DEAN ST
EUREKA CA
95501-3209
US

IV. Provider business mailing address

2306 DEAN ST
EUREKA CA
95501-3209
US

V. Phone/Fax

Practice location:
  • Phone: 707-443-8354
  • Fax: 707-443-8628
Mailing address:
  • Phone: 707-443-8354
  • Fax: 707-443-8628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: HEATHER ELAINE PAUP
Title or Position: OWNER
Credential: PT
Phone: 707-443-8354