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General NPI Number Information
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NPI Number | 1619096336
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Entity Type | Organization
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Legal Business Name | PROTHERAPY, INC.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 137 E VINE ST
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City | REDLANDS
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State | CA
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Zip | 92373-4759
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Country | US
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Telephone | 909-856-3845
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Fax | 909-863-9991
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Provider Business Mailing Address
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Address Line | PO BOX 11268
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City | SAN BERNARDINO
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State | CA
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Zip | 92423-1268
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Country | US
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Telephone | 909-856-3845
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Fax | 909-863-9991
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTIE QUIPANES GUNNARSSON
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Credential | OTR
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Telephone | 909-856-3845
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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 | PT17159
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2416
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT26420
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License Number State | CA
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