Healthcare Provider Details
I. General information
NPI: 1326020868
Provider Name (Legal Business Name): RICHARD P CARR PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2005
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2488 DE LA CRUZ BLVD
SANTA CLARA CA
95050-2923
US
IV. Provider business mailing address
246 SOBRANTE WAY
SUNNYVALE CA
94086-4807
US
V. Phone/Fax
- Phone: 408-247-7278
- Fax: 408-247-9320
- Phone: 408-733-3670
- Fax: 408-245-7968
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANNE
LASSON
Title or Position: VICE PRESIDENT
Credential:
Phone: 408-570-0510