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General NPI Number Information
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NPI Number | 1497963664
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Entity Type | Organization
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Legal Business Name | DASH THERAPY A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/19/2007
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 1827 S. COURT ST SUITE C
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City | VISALIA
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State | CA
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Zip | 93277-5469
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Country | US
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Telephone | 559-627-3274
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Fax | 559-627-3284
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Provider Business Mailing Address
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Address Line | 1827 S COURT ST SUITE C
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City | VISALIA
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State | CA
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Zip | 93277-5469
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Country | US
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Telephone | 559-627-3274
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Fax | 559-627-3284
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | MRS. KIMBERLY CARTER GLICK
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Credential | CHT
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Telephone | 559-627-3274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1497963664
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | BL021941
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License Number State | CA
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