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General NPI Number Information
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NPI Number | 1740399690
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Entity Type | Organization
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Legal Business Name | SACRAMENTO SPINE & PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 11/20/2015
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Provider Practice Location Address
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Address Line | 700 OAK AVENUE PKWY STE B
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City | FOLSOM
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State | CA
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Zip | 95630-6871
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Country | US
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Telephone | 916-932-1210
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2710
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City | GRANITE BAY
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State | CA
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Zip | 95746-2710
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Country | US
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Telephone | 916-932-1210
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRAVIS R SMITH
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Credential |
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Telephone | 916-932-1210
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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 |
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License Number State |
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