Organization
STAC PHYSICAL THERAPY EMERYVILLE, INC.
Active
Other names
Emeryville Sports Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
OR NATIV PT, CSCS (CLINICAL DIRECTOR)
(510) 653-5151
Entity
Organization
Contact information
Practice address
2322 POWELL ST, EMERYVILLE, CA 94608-1738
(626) 825-3739
Mailing address
2322 POWELL ST, EMERYVILLE, CA 94608-1738
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
33997
CA
Other
Enumeration date
08/08/2018
Last updated
07/14/2022
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