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General NPI Number Information
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NPI Number | 1518072180
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Entity Type | Organization
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Legal Business Name | DAN L. CASSADY
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 01/20/2012
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Provider Practice Location Address
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Address Line | 5072 BULLION ST
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City | MARIPOSA
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State | CA
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Zip | 95338
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Country | US
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Telephone | 209-742-7272
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Fax | 209-742-7368
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Provider Business Mailing Address
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Address Line | PO BOX 69
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City | MARIPOSA
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State | CA
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Zip | 95338-0069
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Country | US
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Telephone | 209-742-7272
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Fax | 209-742-7368
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Authorized Official
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Title or Position | OWNER PT
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Name | PROF. DAN LEON CASSADY
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Credential | PT MTC
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Telephone | 209-742-7272
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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 | PT10190
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License Number State | CA
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