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General NPI Number Information
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NPI Number | 1629073788
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Entity Type | Organization
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Legal Business Name | MCCARTHY PHYSICAL THERAPY AND SPORTS CENTER, INC.
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 114 N SUNRISE AVE STE B1
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City | ROSEVILLE
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State | CA
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Zip | 95661-2916
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Country | US
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Telephone | 916-789-1384
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Fax | 916-782-7113
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Provider Business Mailing Address
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Address Line | 114 N SUNRISE AVE STE B1
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City | ROSEVILLE
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State | CA
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Zip | 95661-2916
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Country | US
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Telephone | 916-789-1384
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Fax | 916-782-7113
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MR. TIMOTHY B MCCARTHY
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Credential | PT
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Telephone | 916-789-1384
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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 | PT8842
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License Number State | CA
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