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NPI Code Detail

MEDICARE: HORACE J FERRANTE JR. PT

MEDICARE: HORACE J FERRANTE JR. PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT7859CA
2225100000XPhysical Therapist63891OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT7859OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1013903442
Entity Type Code : Individual
Provider Name (Legal Business Name) : HORACE J FERRANTE JR. PT
Provider Business Mailing Address
First Line : 2645 N 17TH ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2134
Country : US
Telephone Number : 541-266-3658
Fax Number : 541-267-5395
Provider Business Practice Location Address
First Line : 2645 N 17TH ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2134
Country : US
Telephone Number : 541-266-3658
Fax Number : 541-267-5395
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 12/03/2020

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