Organization
INDIVIDUALIZED PHYSICAL THERAPY, INC
Active
Organization
INDIVIDUALIZED PHYSICAL THERAPY, INC
Active
Other names
Individualized Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LEA HALMOS MPT, ATC, CSCS (OWNER/PHYSICAL THERAPIST)
(408) 778-6800
Entity
Organization
Contact information
Practice address
17705 HALE AVE STE H6, MORGAN HILL, CA 95037-4340
(408) 778-6800
(408) 762-4488
Mailing address
17705 HALE AVE STE H6, MORGAN HILL, CA 95037-4340
(408) 778-6800
(408) 762-4488
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ64853Z
BLUE SHIELD OF CA
CA
Enumeration date
02/13/2007
Last updated
08/05/2016
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