| Organization Name: | SPORT AND SPINE THERAPY OF MARIN, INC |
| NPI Number: | 1154388577 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN WILLIAM THOMPSON (PRESIDENT) |
| Mailing Address: | 220 Greenfield Ave San Anselmo |
| State: | CA US |
| Postal Code: | 949602416 |
| Phone Number: | 4154574454 |
| Fax Number: | 4154574944 |
| NPI Enumeration Date: | 04/28/2006 |
| NPI Last Update Date: | 10/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |