Healthcare Provider Details

I. General information

NPI: 1316064819
Provider Name (Legal Business Name): MOTION ONE PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ARCH ST
REDWOOD CITY CA
94062-1305
US

IV. Provider business mailing address

201 ARCH ST
REDWOOD CITY CA
94062-1305
US

V. Phone/Fax

Practice location:
  • Phone: 650-839-0325
  • Fax: 650-568-9053
Mailing address:
  • Phone: 650-839-0325
  • Fax: 650-568-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number17716
License Number StateCA

VIII. Authorized Official

Name: ANTHONY P NICOLETTI
Title or Position: OWNER AND PRESIDENT
Credential: PT
Phone: 650-839-0325