Organization
SCOTT VALLEY PHYSICAL THERAPY AND FITNESS CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS SCOTT KORCEK P. T. (CEO)
(530) 468-5528
Entity
Organization
Contact information
Practice address
122 SCOTT RIVER RD, FORT JONES, CA 96032-9620
(530) 468-5528
Mailing address
PO BOX 217, FORT JONES, CA 96032-0217
(530) 468-5528
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ50708Y
BLUE SHIELD
CA
Enumeration date
05/14/2007
Last updated
05/05/2009
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