MEDICARE: LINDA L AVERY & ASSOCIATES 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	225100000X	Physical Therapist	PT113	CA

General Provider Information

NPI Number	:	1225010283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA L AVERY & ASSOCIATES PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	3300 WEBSTER ST
Second Line	:	SUITE 402
City	:	OAKLAND
State	:	CA
Zip	:	94609-3117
Country	:	US
Telephone Number	:	510-451-6020
Fax Number	:	510-451-6043

Provider Business Practice Location Address
First Line	:	3300 WEBSTER ST
Second Line	:	SUITE 402
City	:	OAKLAND
State	:	CA
Zip	:	94609-3117
Country	:	US
Telephone Number	:	510-451-6020
Fax Number	:	510-451-6043

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	MRS. LINDA LARSSEN AVERY
Credential	:
Telephone Number	:	510-451-6020

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	08/24/2011

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