Provider Demographics
NPI:1285190942
Name:MARKETPLACE PHYSICAL THERAPY INC. APC
Entity Type:Organization
Organization Name:MARKETPLACE PHYSICAL THERAPY INC. APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MISS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-316-3329
Mailing Address - Street 1:3191 MISSION INN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-4188
Mailing Address - Country:US
Mailing Address - Phone:951-684-2874
Mailing Address - Fax:951-684-2980
Practice Address - Street 1:3191 MISSION INN AVE STE B
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-4188
Practice Address - Country:US
Practice Address - Phone:951-376-2692
Practice Address - Fax:951-684-2980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy