MEDICARE: HAHN/WILLIAMSON PHYSICAL THERAPY AND REHABILITATION

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

General Provider Information

NPI Number	:	1548461718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAHN/WILLIAMSON PHYSICAL THERAPY AND REHABILITATION

Provider Business Mailing Address
First Line	:	1505 MERIDIAN AVE
Second Line	:	STE A
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5353
Country	:	US
Telephone Number	:	408-264-6643
Fax Number	:	408-264-6652

Provider Business Practice Location Address
First Line	:	1505 MERIDIAN AVE
Second Line	:	STE A
City	:	SAN JOSE
State	:	CA
Zip	:	95125-5353
Country	:	US
Telephone Number	:	408-264-6643
Fax Number	:	408-264-6652

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN WILLIAMSON
Credential	:	P.T.
Telephone Number	:	408-264-6643

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	02/16/2010

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