Provider Demographics
NPI:1043742653
Name:DB PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:DB PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:B
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-387-5220
Mailing Address - Street 1:PO BOX 593349
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0217
Mailing Address - Country:US
Mailing Address - Phone:210-213-4444
Mailing Address - Fax:830-980-6303
Practice Address - Street 1:36 S 18TH AVE
Practice Address - Street 2:STE. D
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2412
Practice Address - Country:US
Practice Address - Phone:210-213-4444
Practice Address - Fax:830-980-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-02
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0014575225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty