Provider Demographics
NPI:1073664165
Name:TOWER PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:TOWER PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:209-216-3360
Mailing Address - Street 1:1801 COLORADO AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-2706
Mailing Address - Country:US
Mailing Address - Phone:209-216-3360
Mailing Address - Fax:209-216-3365
Practice Address - Street 1:1801 COLORADO AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2706
Practice Address - Country:US
Practice Address - Phone:209-216-3360
Practice Address - Fax:209-216-3365
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWER PHYSICAL THERAPY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-15
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24553225100000X
CA25198225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty