Organization
ORTHOPAEDIC PHYSICAL THERAPY INSTITUTE
Active
Organization
ORTHOPAEDIC PHYSICAL THERAPY INSTITUTE
Active
Other names
OPTI
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGG A OLSEN P.T. (OWNER)
(951) 683-3309
Entity
Organization
Contact information
Practice address
5225 CANYON CREST DR, SUITE 205, RIVERSIDE, CA 92507-6301
(951) 683-3309
(951) 683-1886
Mailing address
5225 CANYON CREST DR, SUITE 205, RIVERSIDE, CA 92507-6301
(951) 683-3309
(951) 683-1886
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF4479
RAILROAD MEDICARE PIN
CA
01
—
ZZZ30613Z
BLUE SHIELD
CA
Enumeration date
04/19/2007
Last updated
11/28/2007
Update your record
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