Healthcare Provider Details

I. General information

NPI: 1356352082
Provider Name (Legal Business Name): BURGER PHYSICAL THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 E BIDWELL ST # 201
FOLSOM CA
95630-3452
US

IV. Provider business mailing address

1301 E BIDWELL ST # 201
FOLSOM CA
95630-3452
US

V. Phone/Fax

Practice location:
  • Phone: 916-983-5915
  • Fax: 916-983-5925
Mailing address:
  • Phone: 916-983-5915
  • Fax: 916-983-5925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License NumberN/A
License Number State

VIII. Authorized Official

Name: MRS. CAROL K BURGER
Title or Position: PRESIDENT
Credential: PT, MPA
Phone: 916-983-5915