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Organization
PHYSICAL THERAPY AT THE HEALTH CLUB
Active
Organization
PHYSICAL THERAPY AT THE HEALTH CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BLENNE HASSETT PT (CO OWNER OF BUSINESS)
(707) 468-3844
Entity
Organization
Contact information
Practice address
3101 SOUTH STATE STREET, SUITE A, UKIAH, CA 95482
(707) 468-3844
(707) 468-5001
Mailing address
3101 SOUTH STATE STREET, SUITE A, UKIAH, CA 95482
(707) 468-3844
(707) 468-5001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT126590
MEDICARE
CA
Enumeration date
10/02/2006
Last updated
10/03/2007
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