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General NPI Number Information
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NPI Number | 1073540399
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Entity Type | Organization
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Legal Business Name | PARRY PHYSICAL THERAPY & ATHLETIC ENHANCEMENT, INC.
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 10/06/2007
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Provider Practice Location Address
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Address Line | 3401 FOLSOM BLVD SUITE B
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City | SACRAMENTO
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State | CA
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Zip | 95816-5354
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Country | US
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Telephone | 916-455-5524
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Fax | 916-455-5524
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Provider Business Mailing Address
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Address Line | 3401 FOLSOM BLVD SUITE B
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City | SACRAMENTO
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State | CA
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Zip | 95816-5354
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Country | US
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Telephone | 916-455-5524
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Fax | 916-455-5524
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Authorized Official
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Title or Position | OWNER
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Name | MR. GREGORY JOHN PARRY
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Credential | PT
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Telephone | 916-455-5524
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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 | PT21001
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License Number State | CA
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