Organization
STITHEM & JOHNSON PHYSICAL THERAPY, INC.
Active
Other names
Orthopaedic and Sports Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN SIERRA NEWHALL B.A. (VP OF ADMIN)
(707) 571-7615
Entity
Organization
Contact information
Practice address
795 FARMERS LN, SANTA ROSA, CA 95405-6718
(707) 571-7615
(707) 571-8601
Mailing address
795 FARMERS LN, SANTA ROSA, CA 95405-6718
(707) 571-7615
(707) 571-8601
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA6103
RAILROAD MEDICARE PTAN
CA
Enumeration date
12/14/2005
Last updated
11/28/2012
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