Organization
BIOSPORT PHYSICAL THERAPY INC
Active
Parent organization
BIOSPORT PHYSICAL THERAPY INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BIOSPORT PHYSICAL THERAPY INC
Authorized official
DR. ALEXANDER EDWARD STAVRIANOUDAKIS DPT (DOCTOR OF PHYSICAL THERAPY/CO-OWNER)
(209) 620-5554
Entity
Organization
Contact information
Practice address
1325 HISTORICAL PLAZA WAY, MANTECA, CA 95336-5064
(209) 524-7488
(209) 522-7488
Mailing address
PO BOX 576751, MODESTO, CA 95357-6751
(209) 524-7488
(209) 522-7488
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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