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Organization
LAKEPORT PHYSICAL THERAPY, INC.
Active
Organization
LAKEPORT PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE H HURST PT (MANAGER)
(707) 263-5210
Entity
Organization
Contact information
Practice address
381 LAKEPORT BLVD, LAKEPORT, CA 95453-5412
(707) 263-5210
(707) 263-8045
Mailing address
381 LAKEPORT BLVD, LAKEPORT, CA 95453-5412
(707) 263-5210
(707) 263-8045
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT17230
CA
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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