Provider Demographics
NPI:1124596101
Name:VILLAGE FITNESS AND PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:VILLAGE FITNESS AND PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLINGLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:916-580-4306
Mailing Address - Street 1:146 N GLENDORA AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-5313
Mailing Address - Country:US
Mailing Address - Phone:626-387-7234
Mailing Address - Fax:
Practice Address - Street 1:146 N GLENDORA AVE STE 106
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-5313
Practice Address - Country:US
Practice Address - Phone:626-387-7234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty