Organization
SPORT & SPINE THERAPY OF MARIN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY ISMAIL (PRESIDENT)
(209) 353-1988
Entity
Organization
Contact information
Practice address
220 GREENFIELD AVE, SAN ANSELMO, CA 94960-2416
(415) 457-4454
(415) 457-4944
Mailing address
220 GREENFIELD AVE, SAN ANSELMO, CA 94960-2416
(415) 457-4454
(415) 457-4944
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
04/28/2006
Last updated
12/06/2023
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