=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316296601
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADEPT PHYSICAL THERAPY FOR WOUND HEALING, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/03/2012
-----------------------------------------------------
Last Update Date | 12/31/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 GARDEN CT SUITE 140
-----------------------------------------------------
City | MONTEREY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93940-5362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-324-4630
-----------------------------------------------------
Fax | 831-324-4709
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 60 GARDEN CT SUITE 140
-----------------------------------------------------
City | MONTEREY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93940-5362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-324-4630
-----------------------------------------------------
Fax | 831-324-4709
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT & CEO
-----------------------------------------------------
Name | JANINE MICHELLE BOYER
-----------------------------------------------------
Credential | P.T.
-----------------------------------------------------
Telephone | 831-324-4630
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------