Organization
C H GRIEVE INC
Active
Other names
Professional Orthopedic and Sports Care of Marin
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEANN KAY JENSEN PT (PHYSICAL THERAPIST CLINIC DIRECTOR)
(415) 454-3838
Entity
Organization
Contact information
Practice address
1299 4TH ST, SUITE 100, SAN RAFAEL, CA 94901
(415) 454-3838
(415) 456-1853
Mailing address
1299 4TH ST, SUITE 100, SAN RAFAEL, CA 94901
(415) 454-3838
(415) 456-1853
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14219
CA
225100000X
Physical Therapist
29868
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ21053Z
GROUP ID
—
Enumeration date
09/12/2006
Last updated
09/18/2008
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