Provider Demographics
NPI:1629490107
Name:PAYNE MURPHY PHYSICAL REHAB
Entity Type:Organization
Organization Name:PAYNE MURPHY PHYSICAL REHAB
Other - Org Name:ALLIANCE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-669-6339
Mailing Address - Street 1:7887 SOQUEL DR
Mailing Address - Street 2:STE. C & D
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3900
Mailing Address - Country:US
Mailing Address - Phone:831-662-4547
Mailing Address - Fax:831-688-1042
Practice Address - Street 1:7887 SOQUEL DR
Practice Address - Street 2:STE. C & D
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-3900
Practice Address - Country:US
Practice Address - Phone:831-662-4547
Practice Address - Fax:831-688-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23060ZMedicare UPIN