Healthcare Provider Details

I. General information

NPI: 1265569396
Provider Name (Legal Business Name): PARROTT ASSOCIATES PHYSTHERAP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E ORANGEBURG AVE SUITE E
MODESTO CA
95350-5355
US

IV. Provider business mailing address

201 E ORANGEBURG AVE SUITE E
MODESTO CA
95350-5355
US

V. Phone/Fax

Practice location:
  • Phone: 209-548-0662
  • Fax: 209-548-0663
Mailing address:
  • Phone: 209-548-0662
  • Fax: 209-548-0663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT18810
License Number StateCA

VIII. Authorized Official

Name: MR. PHILIP ERIC PARROTT
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 209-548-0662