Healthcare Provider Details

I. General information

NPI: 1518902683
Provider Name (Legal Business Name): CRESSWELL PHYSICAL THERAPY AND HAND REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2449 COURT ST
REDDING CA
96001-2525
US

IV. Provider business mailing address

2449 COURT ST
REDDING CA
96001-2525
US

V. Phone/Fax

Practice location:
  • Phone: 530-244-7686
  • Fax: 530-244-9581
Mailing address:
  • Phone: 530-244-7686
  • Fax: 530-244-9581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT13809
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT5351
License Number StateCA

VIII. Authorized Official

Name: MS. SUZANNE MARY CRESSWELL
Title or Position: OWNER ADMINISTRATOR
Credential: PT OT CHT
Phone: 530-244-7686