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General NPI Number Information
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NPI Number | 1336517028
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Entity Type | Organization
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Legal Business Name | INTRINSIC PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 3929 GRAND AVE
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City | OAKLAND
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State | CA
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Zip | 94610-1005
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Country | US
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Telephone | 510-365-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 1526 FRANCISCO ST
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City | BERKELEY
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State | CA
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Zip | 94703-1215
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Country | US
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Telephone | 510-365-9020
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRITT VAN VAN HEES
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Credential | PT
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Telephone | 510-365-9020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | CA
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