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General NPI Number Information
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NPI Number | 1740501022
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Entity Type | Organization
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Legal Business Name | HUMBOLDT PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 1551 GIUNTOLI LN
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City | ARCATA
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State | CA
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Zip | 95521-4495
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Country | US
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Telephone | 707-825-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 GIUNTOLI LN
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City | ARCATA
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State | CA
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Zip | 95521-4495
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Country | US
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Telephone | 707-825-8100
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MR. JAMES H MOORE
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Credential |
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Telephone | 707-825-8100
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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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