Healthcare Provider Details

I. General information

NPI: 1033136726
Provider Name (Legal Business Name): THE PHYSICAL THERAPY CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11335A FOLSOM BLVD
RANCHO CORDOVA CA
95742-6224
US

IV. Provider business mailing address

11335A FOLSOM BLVD
RANCHO CORDOVA CA
95742-6224
US

V. Phone/Fax

Practice location:
  • Phone: 916-858-0950
  • Fax: 916-858-0972
Mailing address:
  • Phone: 916-858-0950
  • Fax: 916-858-0972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARK MCCOY
Title or Position: PRESIDENT
Credential: PT
Phone: 916-747-3302