Provider Demographics
NPI:1568031573
Name:WHITE MOUNTAIN PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:WHITE MOUNTAIN PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-876-4176
Mailing Address - Street 1:14711 PRINCETON AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1465
Mailing Address - Country:US
Mailing Address - Phone:805-876-4176
Mailing Address - Fax:805-290-1994
Practice Address - Street 1:14711 PRINCETON AVE STE 8
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1465
Practice Address - Country:US
Practice Address - Phone:805-876-4176
Practice Address - Fax:805-290-1994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty