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General NPI Number Information
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NPI Number | 1962190413
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Entity Type | Organization
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Legal Business Name | BUDDY & BEAR PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 200 LOWELL CT
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City | DANVILLE
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State | CA
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Zip | 94526-5464
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Country | US
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Telephone | 915-920-6883
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Fax |
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Provider Business Mailing Address
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Address Line | 200 LOWELL CT
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City | DANVILLE
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State | CA
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Zip | 94526-5464
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Country | US
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Telephone | 915-920-6883
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | MAGNOLIA DELA CRUZ MILLS
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Credential | PT
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Telephone | 915-920-6883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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