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General NPI Number Information
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NPI Number | 1962536334
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Entity Type | Organization
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Legal Business Name | CENTER FOR ORTHOPEDIC AND SPINAL PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 1189 E HERNDON AVE STE 106
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City | FRESNO
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State | CA
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Zip | 93720-3167
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Country | US
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Telephone | 559-436-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 1189 E HERNDON AVE STE 106
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City | FRESNO
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State | CA
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Zip | 93720-3167
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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 | PARTNER
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Name | MR. STEVE MATTHEW LASLOVICH
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Credential | PT, DPT, CPED
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Telephone | 559-436-8525
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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 | 9470
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License Number State | CA
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