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General NPI Number Information
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NPI Number | 1356325542
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Entity Type | Individual
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Provider Name | ERIK RICHARD SALLEY PT DPT MA OCS CMDT
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 3505 MADISON ST STE 102
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City | RIVERSIDE
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State | CA
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Zip | 92504-3785
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Country | US
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Telephone | 951-329-3928
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Fax | 951-374-0621
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Provider Business Mailing Address
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Address Line | 3505 MADISON ST STE 102
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City | RIVERSIDE
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State | CA
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Zip | 92504-3785
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Country | US
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Telephone | 951-329-3928
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Fax | 951-374-0621
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 22669
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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 | PT22669
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License Number State | CA
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