Provider Demographics
NPI:1487831616
Name:SAVINA KOLLMORGEN & MARIA KATZ PHYSICAL THERAPIST A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:SAVINA KOLLMORGEN & MARIA KATZ PHYSICAL THERAPIST A PROFESSIONAL CORP
Other - Org Name:BRIGHT STAR PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAVINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOLLMORGEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:818-731-3280
Mailing Address - Street 1:5525 ETIWANDA AVE
Mailing Address - Street 2:SUITE # 110
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3647
Mailing Address - Country:US
Mailing Address - Phone:818-343-3900
Mailing Address - Fax:818-342-8545
Practice Address - Street 1:5525 ETIWANDA AVE
Practice Address - Street 2:SUITE # 110
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3647
Practice Address - Country:US
Practice Address - Phone:818-343-3900
Practice Address - Fax:818-342-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy