Healthcare Provider Details

I. General information

NPI: 1063625663
Provider Name (Legal Business Name): THE NEXT STEP PHYSICAL REPAIR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3446 BROWNS VALLEY RD
VACAVILLE CA
95688-9339
US

IV. Provider business mailing address

PO BOX 208
VACAVILLE CA
95696-0208
US

V. Phone/Fax

Practice location:
  • Phone: 707-447-8462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE KIMSEY
Title or Position: DIRECTOR
Credential:
Phone: 707-447-8462