Provider Demographics
NPI:1194178640
Name:WESTERN PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:WESTERN PHYSICAL THERAPY, INC.
Other - Org Name:PARKSIDE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PHYSICAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-221-9952
Mailing Address - Street 1:PO BOX 493396
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-3396
Mailing Address - Country:US
Mailing Address - Phone:530-221-9952
Mailing Address - Fax:530-221-9910
Practice Address - Street 1:1031 VILLAGE LN
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2812
Practice Address - Country:US
Practice Address - Phone:530-897-0991
Practice Address - Fax:530-897-0997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARKSIDE PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-20
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy