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General NPI Number Information
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NPI Number | 1538247929
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Entity Type | Organization
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Legal Business Name | RIDGE PHYSICAL THERAPY&WELLNESS CENTER
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/29/2007
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Provider Practice Location Address
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Address Line | 5537 BLACK OLIVE DR
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City | PARADISE
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State | CA
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Zip | 95969-4609
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Country | US
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Telephone | 530-877-7744
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Fax | 530-877-7770
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Provider Business Mailing Address
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Address Line | 5537 BLACK OLIVER DRIVE
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City | PARADISE
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State | CA
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Zip | 95969
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Country | US
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Telephone | 530-877-7744
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Fax | 530-877-7770
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MS. TRISHA L HOPPS
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Credential | P.T.
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Telephone | 530-877-7744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OPT176870
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License Number State | CA
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