Provider Demographics
NPI:1558569574
Name:A.O.S. PHYSICAL THERAPY
Entity Type:Organization
Organization Name:A.O.S. PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:RANALLA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-885-3940
Mailing Address - Street 1:11879 KEMPER RD STE 4
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-9021
Mailing Address - Country:US
Mailing Address - Phone:530-885-3940
Mailing Address - Fax:530-885-3984
Practice Address - Street 1:729 SUNRISE AVE
Practice Address - Street 2:SUITE 602
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4565
Practice Address - Country:US
Practice Address - Phone:530-885-3940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7735225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05457ZOtherPHYSICAL THERAPY
CAZZZ24122ZMedicare ID - Type UnspecifiedPHYSICAL THERAPY