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General NPI Number Information
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NPI Number | 1063687531
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Entity Type | Organization
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Legal Business Name | NORTH COUNTY PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 6713 MORRO RD
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City | ATASCADERO
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State | CA
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Zip | 93422-4137
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Country | US
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Telephone | 805-461-5514
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Fax | 805-461-5535
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Provider Business Mailing Address
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Address Line | 1191 E CRESTON RD STE 115
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City | PASO ROBLES
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State | CA
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Zip | 93446-3033
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Country | US
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Telephone | 805-239-3696
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Fax | 805-239-3697
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. MARY ANN BURKE
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Credential | RPT
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Telephone | 805-239-3696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT16770
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License Number State | CA
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