Healthcare Provider Details

I. General information

NPI: 1659471506
Provider Name (Legal Business Name): FROSINI GEORGES P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1973 N TRACY BVLD
TRACY CA
95376
US

IV. Provider business mailing address

1973 N TRACY BVLD
TRACY CA
95376
US

V. Phone/Fax

Practice location:
  • Phone: 209-833-9490
  • Fax: 209-833-9493
Mailing address:
  • Phone: 209-833-9490
  • Fax: 209-833-9493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT 16834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: