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Organization
RICHARD P. CARR PHYSICAL THERAPY INC
Active
Organization
RICHARD P. CARR PHYSICAL THERAPY INC
Active
Other names
Performance Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN DOCKERY (VICE PRESIDENT OF REVENUE CYCLE)
(760) 602-4105
Entity
Organization
Contact information
Practice address
25 N 14TH ST, STE 550, SAN JOSE, CA 95112-6204
(408) 294-3922
(408) 294-4657
Mailing address
PO BOX 612260, SAN JOSE, CA 95161-2260
(877) 325-2776
(408) 945-4011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196223400
DOL
CA
01
—
2534479
CIGNA
CA
01
—
8157014
AETNA
CA
01
—
ZZZ60364Z
BLUESHIELD
CA
Enumeration date
11/22/2005
Last updated
02/05/2016
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