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General NPI Number Information
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NPI Number | 1881793487
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Entity Type | Organization
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Legal Business Name | MOUNTAIN PHYSICAL THERAPY, INC., DBA
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14520 MONO WAY STE 130
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City | SONORA
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State | CA
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Zip | 95370-9500
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Country | US
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Telephone | 209-533-1273
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Fax | 209-522-1382
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Provider Business Mailing Address
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Address Line | 14520 MONO WAY STE 130
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City | SONORA
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State | CA
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Zip | 95370-9500
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Country | US
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Telephone | 209-533-1273
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Fax | 209-533-1382
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDA K ALCORN
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Credential |
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Telephone | 209-533-1273
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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 | PT97780
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License Number State | CA
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