Provider Demographics
NPI:1023037017
Name:ACTION PHYSICAL THERAPY OF MARINA
Entity Type:Organization
Organization Name:ACTION PHYSICAL THERAPY OF MARINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:SCHMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:831-883-9560
Mailing Address - Street 1:266 RESERVATION RD
Mailing Address - Street 2:SUITE F BOX # 142
Mailing Address - City:MARINA
Mailing Address - State:CA
Mailing Address - Zip Code:93933-3179
Mailing Address - Country:US
Mailing Address - Phone:831-883-9560
Mailing Address - Fax:
Practice Address - Street 1:266 RESERVATION RD
Practice Address - Street 2:SUITE O
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-3179
Practice Address - Country:US
Practice Address - Phone:831-883-9560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11697261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy