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Organization
SHASTA LAKE PHYSICAL THERAPY
Active
Organization
SHASTA LAKE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD ROY BAAS P.T. (CO-OWNER / PHYSICAL THERAPIST)
(530) 221-9952
Entity
Organization
Contact information
Practice address
5061 SHASTA DAM BLVD, SHASTA LAKE, CA 96019-9422
(530) 275-0777
(530) 275-8779
Mailing address
PO BOX 493396, REDDING, CA 96049-3396
(530) 221-9952
(530) 221-9554
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00-0004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPT1000840
—
CA
Enumeration date
06/18/2006
Last updated
02/25/2009
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