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Organization
JBJC INC.
Active
Organization
JBJC INC.
Active
Other names
Pine Street Physical & Occupational Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN K BOB DPT (DPT / OWNER / PRESIDENT)
(209) 451-3920
Entity
Organization
Contact information
Practice address
525 S FAIRMONT AVE, SUITE G, LODI, CA 95240-3860
(209) 339-1690
(209) 339-1693
Mailing address
534 E PINE ST, SUITE A, STOCKTON, CA 95204-5536
(209) 463-5800
(209) 463-5900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225XH1200X
Hand Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ23015Z
PROVIDER (PTAN)
CA
Enumeration date
09/08/2014
Last updated
09/08/2014
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