Organization
BIOSPORT PHYSICAL THERAPY TRACY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEOVARDO CHAVEZ MPT, DPT, ATC (CEO/CFO/FOUNDER/PHYSICAL THERAPIST)
(209) 524-7488
Entity
Organization
Contact information
Practice address
2156 W GRANT LINE RD STE 215, TRACY, CA 95377-7337
(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
08/03/2022
Last updated
08/03/2022
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