Provider Demographics
NPI:1194202184
Name:PHYSICAL THERAPY IN-HOME 4U , INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY IN-HOME 4U , INC.
Other - Org Name:PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMAAS
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR
Authorized Official - Phone:619-467-9467
Mailing Address - Street 1:5213 MOUNT ALIFAN DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2620
Mailing Address - Country:US
Mailing Address - Phone:619-467-9467
Mailing Address - Fax:
Practice Address - Street 1:5213 MOUNT ALIFAN DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2620
Practice Address - Country:US
Practice Address - Phone:619-467-9467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy