| Organization Name: | FUQUA PHYSICAL THERAPY |
| NPI Number: | 1962593590 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES SCOTT FUQUA (REGISTERED PHYSICAL THERAPIST OWNER) |
| Mailing Address: | 6560 Greenback Lane #100 Citrus Heights |
| State: | CA US |
| Postal Code: | 95621 |
| Phone Number: | 9167233372 |
| Fax Number: | 9167225098 |
| NPI Enumeration Date: | 09/27/2006 |
| NPI Last Update Date: | 03/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 9856 |
| 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 |