=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548461718
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAHN/WILLIAMSON PHYSICAL THERAPY AND REHABILITATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2007
-----------------------------------------------------
Last Update Date | 02/16/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1505 MERIDIAN AVE STE A
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95125-5353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-264-6643
-----------------------------------------------------
Fax | 408-264-6652
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1505 MERIDIAN AVE STE A
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95125-5353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-264-6643
-----------------------------------------------------
Fax | 408-264-6652
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BRIAN WILLIAMSON
-----------------------------------------------------
Credential | P.T.
-----------------------------------------------------
Telephone | 408-264-6643
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------