Organization
GARY M. DEACON
Active
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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