Organization
PINE MOUNTAIN THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE DEEN TANAKA P.T. (OWNER)
(831) 238-2357
Entity
Organization
Contact information
Practice address
18687 MAIN STREET, GROVELAND, CA 95321
(831) 238-2357
Mailing address
PO BOX 513, GROVELAND, CA 95321-0513
(831) 238-2357
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
27935
CA
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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