Organization
TIBURON PHYSICAL THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN NELSON (CORPORATE SECRETARY)
(415) 435-7488
Entity
Organization
Contact information
Practice address
92 MAIN ST, TIBURON, CA 94920-2508
(415) 435-7488
Mailing address
92 MAIN ST, TIBURON, CA 94920-2508
(415) 435-7488
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT25508
CA
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ22814Z
MEDICARE PTAN
CA
Enumeration date
02/01/2007
Last updated
10/02/2018
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