| Organization Name: | STANFORD AND ASSOCIATES PHYSICAL THERAPY, INC. |
| NPI Number: | 1245296367 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY S STANFORD (PRESIDENT) |
| Mailing Address: | 42007 Fox Farm Rd. Suite #2 Big Bear Lake |
| State: | CA US |
| Postal Code: | 92315 |
| Phone Number: | 9098666202 |
| Fax Number: | 9098666203 |
| NPI Enumeration Date: | 04/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | PT19301 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |