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General NPI Number Information
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NPI Number | 1073369849
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Entity Type | Organization
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Legal Business Name | ACTIVE MOBILE PHYSICAL THERAPY
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 1242 CENTER ST
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City | REDDING
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State | CA
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Zip | 96001-0617
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Country | US
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Telephone | 530-768-8745
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Fax |
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Provider Business Mailing Address
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Address Line | 3477 FOOTBRIDGE CT
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City | REDDING
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State | CA
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Zip | 96003-2184
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Country | US
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Telephone | 530-739-3833
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Fax | 530-418-0944
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. CHRISTIAN MEYER MERCILL
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Credential | DPT
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Telephone | 530-739-3833
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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 |
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License Number State |
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