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General NPI Number Information
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NPI Number | 1366449118
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Entity Type | Organization
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Legal Business Name | FORGERON PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 555 E TACHEVAH DR 1 EAST #201
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City | PALM SPRINGS
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State | CA
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Zip | 92262-5750
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Country | US
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Telephone | 760-778-7150
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Fax | 760-778-7180
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Provider Business Mailing Address
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Address Line | 555 E TACHEVAH DR 1 EAST #201
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City | PALM SPRINGS
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State | CA
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Zip | 92262-5750
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Country | US
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Telephone | 760-778-7150
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Fax | 760-778-7180
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAY A FORGERON
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Credential | PT
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Telephone | 760-778-7150
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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 | PT10849
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License Number State | CA
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