Provider Demographics
NPI:1124226253
Name:MURIETA PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:MURIETA PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:YAMASHIRO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:916-354-0719
Mailing Address - Street 1:PO BOX 955
Mailing Address - Street 2:
Mailing Address - City:RANCHO MURIETA
Mailing Address - State:CA
Mailing Address - Zip Code:95683-0955
Mailing Address - Country:US
Mailing Address - Phone:916-354-0719
Mailing Address - Fax:916-354-1187
Practice Address - Street 1:7281 LONE PINE DR # D104
Practice Address - Street 2:
Practice Address - City:RANCHO MURIETA
Practice Address - State:CA
Practice Address - Zip Code:95683-9715
Practice Address - Country:US
Practice Address - Phone:916-354-0719
Practice Address - Fax:916-354-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy