Provider Demographics
NPI:1619161742
Name:ORTHO-PHYSICALTHERAPY, P.C.
Entity Type:Organization
Organization Name:ORTHO-PHYSICALTHERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:THIEBAUD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PT
Authorized Official - Phone:210-860-7363
Mailing Address - Street 1:5673 VERBENA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1744
Mailing Address - Country:US
Mailing Address - Phone:210-860-7363
Mailing Address - Fax:
Practice Address - Street 1:5673 VERBENA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1744
Practice Address - Country:US
Practice Address - Phone:210-860-7363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy