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General NPI Number Information
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NPI Number | 1861233785
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Entity Type | Organization
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Legal Business Name | XENOPHON THERAPEUTIC RIDING CENTER
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 60 DON GABRIEL WAY
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City | ORINDA
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State | CA
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Zip | 94563-4156
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Country | US
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Telephone | 925-377-0871
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16
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City | ORINDA
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State | CA
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Zip | 94563-0016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MIKHA DIAZ
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Credential |
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Telephone | 925-377-0871
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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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