Doctor Name: | JEREMY RYAN FAUST |
NPI Number: | 1134102544 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICAL THERAPIST |
License Number: | PT28673 |
Business Practice Address: | 860 Southampton Rd Benicia, CA - 945101907 |
Business Phone Number: | 7077456144 |
Business Fax Number: | 7077455698 |
Mailing Address: | 860 Southampton Rd, BENICIA |
State: | CA |
Postal Code: | 94510 |
Phone Number: | 7077456144 |
Fax Number: | 7077455698 |
NPI Enumeration Date: | 11/21/2005 |
NPI Last Update Date: | 05/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT28673 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |