Provider Demographics
NPI:1548408735
Name:DUBLIN PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:DUBLIN PHYSICAL THERAPY, INC
Other - Org Name:SPINE AND SPORTS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-803-0530
Mailing Address - Street 1:6759 SIERRA CT
Mailing Address - Street 2:SUITE A
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2670
Mailing Address - Country:US
Mailing Address - Phone:925-803-0530
Mailing Address - Fax:925-803-2047
Practice Address - Street 1:6759 SIERRA CT
Practice Address - Street 2:SUITE A
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2670
Practice Address - Country:US
Practice Address - Phone:925-803-0530
Practice Address - Fax:925-803-2047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUBLIN PHYSICAL THERAPY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-27
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA225100000XOtherPHYSICAL THERAPIST
CA225100000XOtherPHYSICAL THERAPIST