Provider Demographics
NPI:1336517028
Name:INTRINSIC PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:INTRINSIC PHYSICAL THERAPY INC.
Other - Org Name:INTRINSIC PILATES AND PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRITT
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:VAN HEES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:510-365-9020
Mailing Address - Street 1:1526 FRANCISCO ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1215
Mailing Address - Country:US
Mailing Address - Phone:510-365-9020
Mailing Address - Fax:
Practice Address - Street 1:3929 GRAND AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1005
Practice Address - Country:US
Practice Address - Phone:510-365-9020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-11
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation