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Organization
SEBASTOPOL PHYSICAL THERAPY AND PILATES STUDIO
Active
Organization
SEBASTOPOL PHYSICAL THERAPY AND PILATES STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA DONOVAN MARTINEZ P.T. (OWNER)
(707) 829-3282
Entity
Organization
Contact information
Practice address
100 PLEASANT HILL AVE N, SEBASTOPOL, CA 95472-3104
(707) 829-3282
Mailing address
100 PLEASANT HILL AVE N, SEBASTOPOL, CA 95472-3104
(707) 829-3282
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT13313
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ07609Z
BLUE SHIELD PROVIDER NUMB
CA
Enumeration date
02/13/2007
Last updated
09/25/2007
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