Provider Demographics
NPI:1497061055
Name:PHYSICAL THERAPY ESSSENTIALS
Entity Type:Organization
Organization Name:PHYSICAL THERAPY ESSSENTIALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-701-7818
Mailing Address - Street 1:466 DEL NORTE AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4125
Mailing Address - Country:US
Mailing Address - Phone:530-870-8588
Mailing Address - Fax:530-870-8233
Practice Address - Street 1:466 DEL NORTE AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4125
Practice Address - Country:US
Practice Address - Phone:530-870-8588
Practice Address - Fax:530-870-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11583261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy