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General NPI Number Information
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NPI Number | 1942572011
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Entity Type | Organization
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Legal Business Name | TMI PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 30099 RESERVOIR AVE
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City | NUEVO
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State | CA
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Zip | 92567-9779
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Country | US
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Telephone | 951-928-0773
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Fax | 951-928-2535
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Provider Business Mailing Address
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Address Line | 30099 RESERVOIR AVE
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City | NUEVO
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State | CA
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Zip | 92567-9779
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Country | US
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Telephone | 951-928-0773
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Fax | 951-928-2535
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | TALI M MANTHEY
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Credential | M.P.T.
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Telephone | 951-928-0773
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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 | 25665
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License Number State | CA
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