Healthcare Provider Details

I. General information

NPI: 1699333542
Provider Name (Legal Business Name): VALLEY PERFORMANCE PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2019
Last Update Date: 06/28/2020
Certification Date: 06/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 W OLIVE AVE STE I
MERCED CA
95348-1900
US

IV. Provider business mailing address

1180 W OLIVE AVE STE I
MERCED CA
95348-1900
US

V. Phone/Fax

Practice location:
  • Phone: 818-317-9638
  • Fax:
Mailing address:
  • Phone: 209-626-5350
  • Fax:

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: JOSEPH KLEIN
Title or Position: PHYSICAL THERAPY/CEO
Credential: PT
Phone: 818-317-9638