Organization
GARY M. DEACON
Active
Other names
Sonora Physical Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY DEACON P.T. (OWNER)
(209) 532-6463
Entity
Organization
Contact information
Practice address
181 FAIRVIEW LN, SONORA, CA 95370-4809
(209) 532-6463
(209) 532-3420
Mailing address
181 FAIRVIEW LN, SONORA, CA 95370-4809
(209) 532-6463
(209) 532-3420
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT11939
CA
332B00000X
Durable Medical Equipment & Medical Supplies
PT 11939
CA
Other
Enumeration date
04/23/2007
Last updated
11/02/2011
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