Healthcare Provider Details

I. General information

NPI: 1598283368
Provider Name (Legal Business Name): TRON SETH HARDY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2017
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 INTERNATIONAL CIR BUILDING 2 NORTH 1ST FLOOR PHYSICAL THERAPY
SAN JOSE CA
95119-1130
US

IV. Provider business mailing address

1785 MARLYN WAY
SAN JOSE CA
95125-3427
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-6400
  • Fax:
Mailing address:
  • Phone: 408-463-8103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT293561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: