Provider Demographics
NPI:1083013163
Name:JAM PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:JAM PHYSICAL THERAPY PC
Other - Org Name:PHYAICAL REHAB AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:925-287-0056
Mailing Address - Street 1:175 CLEAVELAND RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3875
Mailing Address - Country:US
Mailing Address - Phone:925-287-0056
Mailing Address - Fax:925-287-0057
Practice Address - Street 1:175 CLEAVELAND RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-3875
Practice Address - Country:US
Practice Address - Phone:925-287-0056
Practice Address - Fax:925-287-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty