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General NPI Number Information
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NPI Number | 1225120397
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Entity Type | Organization
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Legal Business Name | APEX PHYSICAL THERAPY & SPORTS MEDICINE, INC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22511 TWAIN HARTE DR
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City | TWAIN HARTE
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State | CA
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Zip | 95383-9628
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Country | US
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Telephone | 209-586-4689
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Fax | 209-586-2309
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Provider Business Mailing Address
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Address Line | 22511 TWAIN HARTE DR
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City | TWAIN HARTE
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State | CA
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Zip | 95383-9628
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Country | US
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Telephone | 209-586-4689
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Fax | 209-586-2309
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Authorized Official
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Title or Position | PRESIDENT PHYSICAL THERAPIST
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Name | MR. DAVID A HARTWIG
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Credential | P T
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Telephone | 209-586-4689
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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 | 22617
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License Number State | AZ
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