Organization
STITHEM & JOHNSON PHYSICAL THERAPY INC.
Active
Other names
Orthopaedic & Sports Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MEGAN SIERRA NEWHALL BA (CLINIC ADMINISTRATOR)
(707) 571-7615
Entity
Organization
Contact information
Practice address
6574 OAKMONT DR, STE A, SANTA ROSA, CA 95409-5958
(707) 539-5256
(707) 539-7914
Mailing address
795 FARMERS LN, STE 10, SANTA ROSA, CA 95405-6718
(707) 571-7615
(707) 571-8601
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA6103
RAILROAD MEDICARE PTAN
CA
Enumeration date
10/03/2007
Last updated
08/14/2013
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