Provider Demographics
NPI:1457817157
Name:PLACER PHYSICAL THERAPY & SPORTS MEDICINE, INC
Entity Type:Organization
Organization Name:PLACER PHYSICAL THERAPY & SPORTS MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:916-853-0255
Mailing Address - Street 1:670 AUBURN FOLSOM RD STE 106
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5647
Mailing Address - Country:US
Mailing Address - Phone:916-853-0255
Mailing Address - Fax:
Practice Address - Street 1:670 AUBURN FOLSOM RD STE 106
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5647
Practice Address - Country:US
Practice Address - Phone:916-853-0255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty