Organization
HAMMER GOLF PERFORMANCE AND FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JACKLYN JOAN EGNOR (OFFICE MANAGER)
(408) 558-9518
Entity
Organization
Contact information
Practice address
891 E HAMILTON AVE, CAMPBELL, CA 95008-0614
(408) 558-9518
(408) 558-9528
Mailing address
891 E HAMILTON AVE, CAMPBELL, CA 95008-0614
(408) 558-9518
(408) 558-9528
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
19820
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17070
PHYSICAL THERAPY LICENSE
CA
01
—
19820
PHYSICAL THERAPY LICENSE
CA
Enumeration date
03/19/2007
Last updated
08/22/2020
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