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General NPI Number Information
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NPI Number | 1679718555
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/08/2008
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Last Update Date | 12/08/2008
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Provider Practice Location Address
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Address Line | 3254 MAIN STREET
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City | COTTONWOOD
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State | CA
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Zip | 96022
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Country | US
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Telephone | 530-347-2220
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Fax | 530-347-2227
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Provider Business Mailing Address
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Address Line | PO BOX 980
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City | COTTONWOOD
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State | CA
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Zip | 96022-0980
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Country | US
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Telephone | 530-347-2220
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Fax | 530-347-2227
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. THOMAS S REUSS
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Credential | MSPT
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Telephone | 530-347-2220
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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 | PT25699
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License Number State | CA
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