Organization
TAYLOR & THORNBURG PHYSICAL THERAPY, INC.
Active
Other names
Fyzical Therapy & Balance CTR Oakland
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN SMITH THORNBURG P.T. (OFFICER OF CORPORATION)
(510) 893-8878
Entity
Organization
Contact information
Practice address
3718 GRAND AVE, SUITE 15, OAKLAND, CA 94610-1544
(510) 893-8878
(510) 893-8879
Mailing address
3718 GRAND AVE, SUITE 15, OAKLAND, CA 94610-1544
(510) 893-8878
(510) 893-8879
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ 07432 Z
MEDICARE PTAN
—
Enumeration date
01/14/2008
Last updated
12/03/2019
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