=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649320813
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THOMAS REED PHYSICAL THERAPY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2007
-----------------------------------------------------
Last Update Date | 06/18/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7232 VAN NUYS BLVD STE 203
-----------------------------------------------------
City | VAN NUYS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91405-2231
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-786-9012
-----------------------------------------------------
Fax | 818-786-5729
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 22647 VENTURA BLVD # 358
-----------------------------------------------------
City | WOODLAND HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91364-1416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-786-9012
-----------------------------------------------------
Fax | 818-786-5729
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MERLE THOMAS REED
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 818-786-9012
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------