Organization
BOB NYE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT L NYE P.T. (OWNER)
(805) 735-8365
Entity
Organization
Contact information
Practice address
1101 E OCEAN AVE, LOMPOC, CA 93436-7096
(805) 735-8365
(805) 735-1604
Mailing address
1101 E OCEAN AVE, LOMPOC, CA 93436-7096
(805) 735-8365
(805) 735-1604
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT11160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT0111600
MEDI-CAL
CA
Enumeration date
12/15/2005
Last updated
08/22/2020
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