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NPI Code Detail

MEDICARE: HOWARD & TIBBETTS PHYSICAL THERAPY, INC.

MEDICARE: HOWARD & TIBBETTS 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
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ60815ZZOTHERCABLUE SHIELD ID #

General Provider Information

NPI Number : 1730182163
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOWARD & TIBBETTS PHYSICAL THERAPY, INC.
Provider Business Mailing Address
First Line : 4615 SCOTTS VALLEY DR
Second Line : SUITE D
City : SCOTTS VALLEY
State : CA
Zip : 95066-4278
Country : US
Telephone Number : 831-438-4478
Fax Number :
Provider Business Practice Location Address
First Line : 13350 WEST PARK AVE
Second Line : STE A2
City : BOULDER CREEK
State : CA
Zip : 95006
Country : US
Telephone Number : 831-338-4458
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. CHERYL DENISE TIBBETTS
Credential : P.T.
Telephone Number : 831-438-4478
Provider Enumeration Date : 05/31/2005
Last Update Date : 04/03/2009

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Directions to “HOWARD & TIBBETTS PHYSICAL THERAPY, INC. ” Practice Location

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