MEDICARE: WHERE THE MIND GROWS 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1477323830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHERE THE MIND GROWS PHYSICAL THERAPY INC.

Provider Business Mailing Address
First Line	:	3519 43RD ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-3731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3519 43RD ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-3731
Country	:	US
Telephone Number	:	707-477-0063
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALYSSA BRESLIN
Credential	:	DPT
Telephone Number	:	707-477-0063

Provider Enumeration Date	:	01/08/2024
Last Update Date	:	01/08/2024

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