Provider Demographics
NPI:1376214486
Name:PARKWAY PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:PARKWAY PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:FOLSOM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:760-470-3902
Mailing Address - Street 1:4040 BERRENDO DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-3023
Mailing Address - Country:US
Mailing Address - Phone:760-470-3902
Mailing Address - Fax:
Practice Address - Street 1:800 HOWE AVE STE 400
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3913
Practice Address - Country:US
Practice Address - Phone:760-470-3902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty