Provider Demographics
NPI:1568423952
Name:VTC ENTERPRISES
Entity Type:Organization
Organization Name:VTC ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-928-5000
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93456-1187
Mailing Address - Country:US
Mailing Address - Phone:805-928-5000
Mailing Address - Fax:805-922-6443
Practice Address - Street 1:2445 A STREET
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455
Practice Address - Country:US
Practice Address - Phone:805-928-5000
Practice Address - Fax:805-922-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18782Medicare UPIN