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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