Healthcare Provider Details

I. General information

NPI: 1003350802
Provider Name (Legal Business Name): RICHARD P. CARR PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2016
Last Update Date: 12/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15215 NATIONAL AVE SUITE 100A
LOS GATOS CA
95032-2425
US

IV. Provider business mailing address

500 E CALAVERAS BLVD SUITE 112
MILPITAS CA
95035-7703
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-7326
  • Fax:
Mailing address:
  • Phone: 408-934-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATE ZITTERE
Title or Position: CONTROLLER
Credential:
Phone: 76060241036