Provider Demographics
NPI:1497196794
Name:PHYSIUS PHYSICAL THERAPY & WELLNESS
Entity Type:Organization
Organization Name:PHYSIUS PHYSICAL THERAPY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:L
Authorized Official - Last Name:SILVEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:559-381-1024
Mailing Address - Street 1:1900 W RIO HONDO WAY
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-1113
Mailing Address - Country:US
Mailing Address - Phone:559-381-1024
Mailing Address - Fax:
Practice Address - Street 1:716 GARNER AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4313
Practice Address - Country:US
Practice Address - Phone:559-381-1024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22843261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy