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General NPI Number Information
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NPI Number | 1336407139
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Entity Type | Organization
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Legal Business Name | NORTH AREA PHYSICAL THERAPY AND AQUATIC THERAPY
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Dates
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Enumeration Date | 04/30/2012
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Last Update Date | 09/03/2012
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Provider Practice Location Address
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Address Line | 4737 EL CAMINO AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-4938
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Country | US
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Telephone | 916-487-3473
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Fax |
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Provider Business Mailing Address
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Address Line | 4737 EL CAMINO AVE
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City | CARMICHAEL
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State | CA
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Zip | 95608-4938
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Country | US
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Telephone | 916-487-3473
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHYSICAL THERAPIST
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Name | MR. ALEXANDER RAY
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Credential | P.T.
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Telephone | 916-616-2179
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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 | 43202
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License Number State | CA
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