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General NPI Number Information
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NPI Number | 1841061561
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Entity Type | Organization
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Legal Business Name | SUMNER PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 9425 PRINCIPAL AVE
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City | ATASCADERO
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State | CA
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Zip | 93422-5589
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Country | US
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Telephone | 805-591-0966
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Fax | 805-460-6191
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Provider Business Mailing Address
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Address Line | 9425 PRINCIPAL AVE
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City | ATASCADERO
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State | CA
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Zip | 93422-5589
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Country | US
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Telephone | 805-591-0966
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Fax | 805-460-6191
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Authorized Official
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Title or Position | CEO/PT
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Name | MR. ETHAN SUMNER APP
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Credential | PT
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Telephone | 805-591-0966
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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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