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General NPI Number Information
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NPI Number | 1407010242
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Entity Type | Organization
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Legal Business Name | SNOWVIEW PHYSICAL THERAPY
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 09/22/2008
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Provider Practice Location Address
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Address Line | 3936 PHELAN RD STE B9
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City | PHELAN
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State | CA
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Zip | 92371-4141
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Country | US
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Telephone | 760-868-0800
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Fax | 760-868-0822
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Provider Business Mailing Address
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Address Line | 3936 PHELAN RD STE B9
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City | PHELAN
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State | CA
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Zip | 92371-4141
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Country | US
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Telephone | 760-868-0800
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Fax | 760-868-0822
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | WILLIAM B MASHTALIER
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Credential | MPT, GCS
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Telephone | 760-868-0800
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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 |
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License Number State |
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