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General NPI Number Information
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NPI Number | 1184163347
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Entity Type | Organization
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Legal Business Name | LADY BITS PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 3010 FREEPORT BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95818-4340
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Country | US
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Telephone | 916-588-0054
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Fax |
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Provider Business Mailing Address
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Address Line | 3010 FREEPORT BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95818-4340
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Country | US
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Telephone | 916-588-0054
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE KWONG
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Credential | PT
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Telephone | 916-588-0054
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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 | PT39935
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License Number State | CA
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