Organization Name: | GRANITE BAY PHYSICAL THERAPY |
NPI Number: | 1306904594 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER HEADRICK (OWNER) |
Mailing Address: | 6910 Douglas Blvd Suite D Granite Bay |
State: | CA US |
Postal Code: | 957466276 |
Phone Number: | 9167915011 |
Fax Number: | 9167913211 |
NPI Enumeration Date: | 12/04/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT27707 |
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 |