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General NPI Number Information
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NPI Number | 1063510337
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Entity Type | Organization
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Legal Business Name | SILVER CREEK FITNESS AND PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 4205 SAN FELIPE RD SUITE 100
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City | SAN JOSE
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State | CA
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Zip | 95135-1503
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Country | US
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Telephone | 408-841-7203
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 858
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City | FRANKLIN
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State | TN
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Zip | 37065-0858
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Country | US
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Telephone | 408-238-1552
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BOBBY ISMAIL
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Credential | DPT
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Telephone | 209-353-1988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | CA
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