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General NPI Number Information
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NPI Number | 1639754245
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Entity Type | Organization
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Legal Business Name | NETIC PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 03/15/2021
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 1390 MARKET ST STE 200
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-5404
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Country | US
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Telephone | 510-761-9354
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Fax | 949-276-3039
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Provider Business Mailing Address
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Address Line | 2208 DWIGHT WAY APT 5
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City | BERKELEY
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State | CA
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Zip | 94704-2143
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Country | US
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Telephone | 510-761-9354
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SUSAN CATHERINE NOWELL
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Credential | DPT
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Telephone | 415-205-0781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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