MEDICARE: HELIX PERFORMANCE PHYSICAL THERAPY, INC

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
1	2251X0800X	Orthopedic Physical Therapist
2	2251S0007X	Sports Physical Therapist

General Provider Information

NPI Number	:	1093546624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELIX PERFORMANCE PHYSICAL THERAPY, INC

Provider Business Mailing Address
First Line	:	3420 FOSTORIA WAY STE A100
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-5570
Country	:	US
Telephone Number	:	925-222-5101
Fax Number	:	925-233-3313

Provider Business Practice Location Address
First Line	:	3420 FOSTORIA WAY STE A100
Second Line	:
City	:	DANVILLE
State	:	CA
Zip	:	94526-5570
Country	:	US
Telephone Number	:	925-222-5101
Fax Number	:	925-233-3313

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WESTON ANDERSON
Credential	:	PT DPT
Telephone Number	:	925-222-5101

Provider Enumeration Date	:	08/14/2024
Last Update Date	:	08/14/2024

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