Provider Demographics
NPI:1003350802
Name:RICHARD P. CARR PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:RICHARD P. CARR PHYSICAL THERAPY INC
Other - Org Name:PERFORMANCE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZITTERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7606-024-1036
Mailing Address - Street 1:500 E CALAVERAS BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7703
Mailing Address - Country:US
Mailing Address - Phone:408-934-4700
Mailing Address - Fax:
Practice Address - Street 1:15215 NATIONAL AVE
Practice Address - Street 2:SUITE 100A
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2425
Practice Address - Country:US
Practice Address - Phone:408-358-7326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty