Organization
AQUATIC THERAPY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARYL SIRCUS (EXECUTIVE DIRECTOR)
(415) 507-9800
Entity
Organization
Contact information
Practice address
200 N SAN PEDRO RD, SAN RAFAEL, CA 94903-4213
(415) 507-9800
Mailing address
4460 16 REDWOOD HWY #404, SAN RAFAEL, CA 94903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT16863
CA
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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