Organization
SCOTT VALLEY PHYSICAL THERAPY AND FITNESS CENTER, PC
Active
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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