Organization
GOLDEN BEAR PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICOLAS KING PTA (PHYSICAL THERAPIST ASSISTANT)
(209) 576-0888
Entity
Organization
Contact information
Practice address
4318 SPYRES WAY, MODESTO, CA 95356-9259
(209) 576-0888
(209) 576-0913
Mailing address
4318 SPYRES WAY, MODESTO, CA 95356-9259
(209) 576-0888
(209) 576-0913
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT11025
CA
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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