| Organization Name: | TIBURON PHYSICAL THERAPY CENTER INC |
| NPI Number: | 1235277625 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTEN NELSON (CORPORATE SECRETARY) |
| Mailing Address: | 92 Main St Tiburon |
| State: | CA US |
| Postal Code: | 949202508 |
| Phone Number: | 4154357488 |
| Fax Number: | |
| NPI Enumeration Date: | 02/01/2007 |
| NPI Last Update Date: | 04/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PT25508 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |