Organization
SHINING STAR CHILDREN'S THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE MARIE CONCA MPT (OWNER/THERAPIST)
(530) 306-3469
Entity
Organization
Contact information
Practice address
4287 SLY PARK RD, POLLOCK PINES, CA 95726-9007
(866) 306-3469
(866) 615-6143
Mailing address
PO BOX 34120, RENO, NV 89533-4120
(775) 747-5050
(775) 747-5005
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
20271
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20271
PT LICENSE
CA
Enumeration date
04/02/2014
Last updated
04/02/2014
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