Organization
FOLSOM PHYSICAL THERAPY AND TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY EUGENE MCGONIGLE P.T. (PHYSICAL THERAPIST, CO-OWNER)
(916) 355-8500
Entity
Organization
Contact information
Practice address
115 NATOMA ST, FOLSOM, CA 95630-2615
(916) 355-8500
(916) 355-8196
Mailing address
115 NATOMA ST, FOLSOM, CA 95630-2615
(916) 355-8500
(916) 355-8196
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
0603009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ61124Z
BLUE SHIELD
CA
Enumeration date
07/08/2006
Last updated
12/02/2008
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