Healthcare Provider Details

I. General information

NPI: 1639583602
Provider Name (Legal Business Name): THERAPYDIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 18TH ST NW SUITE 1000
WASHINGTON DC
20006-3513
US

IV. Provider business mailing address

18 E BLITHEDALE AVE STE 21 SUITE 21
MILL VALLEY CA
94941-1946
US

V. Phone/Fax

Practice location:
  • Phone: 415-533-4863
  • Fax:
Mailing address:
  • Phone: 415-533-4863
  • Fax:

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: LEAH NOTTINGHAM
Title or Position: VP, CLINIC SERVICES
Credential:
Phone: 415-533-4863