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Organization
TELEPHYSIO PHYSICAL THERAPY INCORPORATED
Active
Organization
TELEPHYSIO PHYSICAL THERAPY INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN PIERCE COSTA PT (PRESIDENT, CFO, SECRETARY)
(415) 497-4841
Entity
Organization
Contact information
Practice address
51 LOCHINVAR RD, SAN RAFAEL, CA 94901-2446
(415) 497-4841
Mailing address
51 LOCHINVAR RD, SAN RAFAEL, CA 94901-2446
(415) 497-4841
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/06/2020
Last updated
09/06/2023
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