Provider Demographics
NPI:1619398062
Name:ORTHOPEDIC PHYSICAL THERAPY INSTITUTE, INC.
Entity Type:Organization
Organization Name:ORTHOPEDIC PHYSICAL THERAPY INSTITUTE, INC.
Other - Org Name:OPTI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTELINK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:209-312-9739
Mailing Address - Street 1:4028 DALE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9561
Mailing Address - Country:US
Mailing Address - Phone:209-312-9739
Mailing Address - Fax:209-312-9747
Practice Address - Street 1:4028 DALE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9561
Practice Address - Country:US
Practice Address - Phone:209-312-9739
Practice Address - Fax:209-312-9747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-01
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT35400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy