Provider Demographics
NPI:1316211857
Name:O PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:O PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-604-8264
Mailing Address - Street 1:PO BOX 1785
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-1785
Mailing Address - Country:US
Mailing Address - Phone:530-604-8264
Mailing Address - Fax:888-387-5007
Practice Address - Street 1:1293 E 1ST AVE STE B
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1548
Practice Address - Country:US
Practice Address - Phone:530-604-8264
Practice Address - Fax:888-387-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT19652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty