Provider Demographics
NPI:1619195161
Name:DINUBA PHYSICAL THERAPY
Entity Type:Organization
Organization Name:DINUBA PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-591-4411
Mailing Address - Street 1:820 N ALTA AVE STE K
Mailing Address - Street 2:
Mailing Address - City:DINUBA
Mailing Address - State:CA
Mailing Address - Zip Code:93618-3083
Mailing Address - Country:US
Mailing Address - Phone:559-591-4411
Mailing Address - Fax:559-591-4309
Practice Address - Street 1:820 N ALTA AVE STE K
Practice Address - Street 2:
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-3083
Practice Address - Country:US
Practice Address - Phone:559-591-4411
Practice Address - Fax:559-591-4309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 118830261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT118830Medicare ID - Type Unspecified