Provider Demographics
NPI:1639534225
Name:PRECISION PHYSICAL THERAPY & FITNESS
Entity Type:Organization
Organization Name:PRECISION PHYSICAL THERAPY & FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:VEGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:831-464-8200
Mailing Address - Street 1:8030 SOQUEL AVE
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2096
Mailing Address - Country:US
Mailing Address - Phone:831-464-8200
Mailing Address - Fax:831-295-6735
Practice Address - Street 1:8030 SOQUEL AVE
Practice Address - Street 2:SUITE #200
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2096
Practice Address - Country:US
Practice Address - Phone:831-464-8200
Practice Address - Fax:831-295-6735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20895225100000X
CAAT4709225200000X
CAOT2579225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty