Organization
NOVATO BACK CARE AND SPORTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN WILLIAM THOMPSON MPT, OCS (CEO)
(415) 898-1311
Entity
Organization
Contact information
Practice address
165 ROWLAND WAY, SUITE 101, NOVATO, CA 94945-5038
(415) 898-1311
(415) 897-0741
Mailing address
165 ROWLAND WAY, SUITE 101, NOVATO, CA 94945-5038
(415) 898-1311
(415) 897-0741
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ17635Z
MEDICARE PTAN
CA
Enumeration date
07/22/2009
Last updated
07/22/2009
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