Healthcare Provider Details

I. General information

NPI: 1902823693
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: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10390 COLOMA ROAD SUITE 7
RANCHO CORDOVA CA
95670-2152
US

IV. Provider business mailing address

10390 COLOMA ROAD SUITE 7
RANCHO CORDOVA CA
95670-2152
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: MRS. JAMIE BRINKER
Title or Position: DEPUTY CEO
Credential:
Phone: 916-759-8681