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General NPI Number Information
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NPI Number | 1447795166
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Entity Type | Organization
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Legal Business Name | CLT, INC.
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Dates
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Enumeration Date | 01/04/2017
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Last Update Date | 01/04/2017
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Provider Practice Location Address
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Address Line | 786 LIGHTHOUSE AVE
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City | MONTEREY
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State | CA
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Zip | 93940-1010
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Country | US
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Telephone | 831-645-9996
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Fax | 831-645-9997
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Provider Business Mailing Address
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Address Line | 786 LIGHTHOUSE AVE
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City | MONTEREY
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State | CA
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Zip | 93940-1010
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Country | US
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Telephone | 831-645-9996
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Fax | 831-645-9997
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | CHRISTOPHER LEE TINKER
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Credential | DPT
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Telephone | 831-645-9996
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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 | PT24031
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License Number State | CA
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