Healthcare Provider Details

I. General information

NPI: 1053664128
Provider Name (Legal Business Name): LOCAL MOTION PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1628A CALIFORNIA STREET
SAN FRANCISCO CA
94109
US

IV. Provider business mailing address

1628A CALIFORNIA STREET
SAN FRANCISCO CA
94109
US

V. Phone/Fax

Practice location:
  • Phone: 415-694-9451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number34892
License Number StateCA

VIII. Authorized Official

Name: TARA MCGANN FRIEDMAN
Title or Position: PT, CEO
Credential: DPT
Phone: 415-694-9451