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Organization
MOMENTUM PHYSICAL THERAPY
Active
Organization
MOMENTUM PHYSICAL THERAPY
Active
Other names
Momentum Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE LASSON (VICE PRESIDENT)
(408) 570-0510
Entity
Organization
Contact information
Practice address
3718 MCDONALD AVE, RICHMOND, CA 94804
(510) 965-0811
(510) 965-0815
Mailing address
PO BOX 612260, SAN JOSE, CA 95161-2260
(877) 325-2776
(408) 945-4011
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225XE1200X
Ergonomics Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7092476
AETNA
CA
01
—
937082
CIGNA
CA
01
—
OPT146460
BLUE SHIELD
—
Enumeration date
11/18/2005
Last updated
10/08/2007
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