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Organization
SUSANVILLE THERAPY ATHLETIC REHABILITATION
Active
Organization
SUSANVILLE THERAPY ATHLETIC REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN C HUBBARD RPT (PHYSICAL THERAPIST)
(530) 257-8989
Entity
Organization
Contact information
Practice address
711 MAIN ST, SUSANVILLE, CA 96130-4329
(530) 257-8989
(530) 257-4649
Mailing address
711 MAIN ST, SUSANVILLE, CA 96130-4329
(530) 257-8989
(530) 257-4649
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT12628
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PT126280
BLUE CROSS
CA
01
—
ZZZ41322Z
BLUE SHIELD
CA
Enumeration date
05/24/2007
Last updated
08/22/2020
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