Provider Demographics
NPI:1407503634
Name:SANTA CRUZ MEDICAL THERAPY UNIT
Entity Type:Organization
Organization Name:SANTA CRUZ MEDICAL THERAPY UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:SANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:831-247-9501
Mailing Address - Street 1:1430 FREEDOM BLVD SUITE A
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076
Mailing Address - Country:US
Mailing Address - Phone:831-465-0390
Mailing Address - Fax:831-465-0391
Practice Address - Street 1:987 BOSTWICK LANE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062
Practice Address - Country:US
Practice Address - Phone:831-465-0390
Practice Address - Fax:831-465-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy