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General NPI Number Information
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NPI Number | 1194028654
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Entity Type | Organization
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Legal Business Name | PROPLAY PEDIATRIC PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 2100 VALLEY VIEW PKWY SUITE 1332
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-5536
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Country | US
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Telephone | 916-899-7653
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 VALLEY VIEW PKWY., # 1332
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City | EL DORADO HILLS
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State | CA
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Zip | 95762
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Country | US
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Telephone | 916-837-0561
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. JOE JOHN GARCIA
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Credential |
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Telephone | 916-899-7653
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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 | 15318
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 24980
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License Number State | CA
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