Organization
ARROYO GRANDE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK JOHN FORD PT (PT OWNER)
(805) 481-5656
Entity
Organization
Contact information
Practice address
117 SO HALCYON ROAD, ARROYO GRANDE, CA 93420-3115
(805) 481-5656
(805) 481-5749
Mailing address
117 SO HALCYON ROAD, ARROYO GRANDE, CA 93420-3115
(805) 481-5656
(805) 481-5749
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6466
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W16678
MEDICARE GROUP #
CA
01
—
ZZZ95472Z
BLUE SHIELD
—
Enumeration date
05/18/2006
Last updated
10/11/2007
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