Healthcare Provider Details

I. General information

NPI: 1053406371
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 W 11TH ST STE 109
TRACY CA
95376-3858
US

IV. Provider business mailing address

2300 COIT RD SUITE 300
PLANO TX
75075-3768
US

V. Phone/Fax

Practice location:
  • Phone: 209-834-2314
  • Fax: 209-834-2176
Mailing address:
  • Phone: 469-467-8705
  • Fax: 267-321-2550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD S. BINSTEIN
Title or Position: EXECUTIVE VICE PRESIDENTD
Credential:
Phone: 610-644-7824