Provider Demographics
NPI:1073796462
Name:PHYSICAL THERAPY UNLIMITED, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY UNLIMITED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CHENNAULT
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:559-585-8087
Mailing Address - Street 1:1489 W LACEY BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5957
Mailing Address - Country:US
Mailing Address - Phone:559-585-8087
Mailing Address - Fax:559-585-1933
Practice Address - Street 1:1489 W LACEY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5957
Practice Address - Country:US
Practice Address - Phone:559-585-8087
Practice Address - Fax:559-585-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy