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General NPI Number Information
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NPI Number | 1992717342
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Entity Type | Organization
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Legal Business Name | PETER CHIRICO
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 04/10/2013
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Provider Practice Location Address
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Address Line | 2601 W ALAMEDA AVE SUITE 308
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City | BURBANK
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State | CA
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Zip | 91505-4814
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Country | US
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Telephone | 818-972-2811
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Fax | 818-972-2918
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Provider Business Mailing Address
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Address Line | 2601 W ALAMEDA AVE SUITE 308
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City | BURBANK
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State | CA
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Zip | 91505-4814
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Country | US
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Telephone | 818-972-2811
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Fax | 818-972-2918
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Authorized Official
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Title or Position | OWNER ADMINISTRATOR
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Name | MR. PETER CHIRICO
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Credential | PT
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Telephone | 818-972-2811
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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 | PT8303
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License Number State | CA
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