Provider Demographics
NPI:1235165515
Name:WESTERN PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:WESTERN PHYSICAL THERAPY, INC.
Other - Org Name:DURHAM PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ROY
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:530-221-9954
Practice Address - Street 1:9341 MIDWAY
Practice Address - Street 2:SUITE C
Practice Address - City:DURHAM
Practice Address - State:CA
Practice Address - Zip Code:95938-9785
Practice Address - Country:US
Practice Address - Phone:530-343-2010
Practice Address - Fax:530-343-2012
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTERN PHYSICAL THERAPY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-25
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03679ZMedicare ID - Type UnspecifiedMEDICARE NUMBER