Doctor Name: | AUTUMN AMBROSE KING |
NPI Number: | 1518130244 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | PT 34574 |
Business Practice Address: | 670 E Calaveras Blvd Milpitas, CA - 950355442 |
Business Phone Number: | 4089344700 |
Business Fax Number: | 4089344701 |
Mailing Address: | 246 Sobrante Way, SUNNYVALE |
State: | CA |
Postal Code: | 940864807 |
Phone Number: | 4087333670 |
Fax Number: | 4082457968 |
NPI Enumeration Date: | 04/02/2008 |
NPI Last Update Date: | 12/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 34574 |
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 |