Healthcare Provider Details
I. General information
NPI: 1306215850
Provider Name (Legal Business Name): WESTERN PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2015
Last Update Date: 11/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1225 EUREKA WAY SUITE B
REDDING CA
96001-0815
US
IV. Provider business mailing address
PO BOX 493396
REDDING CA
96049-3396
US
V. Phone/Fax
- Phone: 530-247-1280
- Fax: 530-247-0310
- Phone: 530-221-9952
- Fax: 530-221-9910
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DONALD
R
BAAS
Title or Position: CEO/PHYSICAL THERAPIST, OWNER
Credential: PT
Phone: 530-221-9952