Organization
AMADOR PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOLYNN GRIJALVA P.T. (OFFICE MANAGER)
(209) 223-3250
Entity
Organization
Contact information
Practice address
813 COURT ST, STE2, JACKSON, CA 95642-2131
(209) 223-3250
(209) 223-2517
Mailing address
813 COURT ST, STE2, JACKSON, CA 95642-2131
(209) 223-3250
(209) 223-2517
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650008609
RAILROAD MEDICARE
CA
01
—
ZZZ54629Z
BLUE SHIELD
CA
Enumeration date
05/08/2006
Last updated
01/21/2010
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