Individual
CHARLES T SPINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT,JSCC,CEAS
Contact information
Practice address
7005 N MAPLE AVE, SUITE 104, FRESNO, CA 93720-8009
(559) 325-3503
(559) 325-3504
Mailing address
6596 N RAISINA AVE, FRESNO, CA 93710-3945
(916) 214-3941
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT15431
CA
2251E1200X
Ergonomics Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK761U
MEDICARE PTAN
CA
Enumeration date
05/10/2007
Last updated
04/02/2013
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