Organization
O'DONNELL PHYSICAL THERAPY CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN O'DONNELL PT (PRESIDENT AND SECRETARY)
(916) 847-3548
Entity
Organization
Contact information
Practice address
108 VAN WINKLE CT, FOLSOM, CA 95630-1962
(916) 847-3548
(916) 988-1106
Mailing address
108 VAN WINKLE CT, FOLSOM, CA 95630-1962
(916) 847-3548
(916) 988-1106
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT27002
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT270023
MEDICARE ID
CA
01
—
1164511010
NPI
—
Enumeration date
11/08/2011
Last updated
11/08/2011
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