Provider Demographics
NPI:1679541494
Name:TODRANK, HENRY CRAIG (PT)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:CRAIG
Last Name:TODRANK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 BALBOA DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4925
Mailing Address - Country:US
Mailing Address - Phone:916-783-8628
Mailing Address - Fax:
Practice Address - Street 1:2921 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6012
Practice Address - Country:US
Practice Address - Phone:916-483-4884
Practice Address - Fax:916-483-4890
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT8379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist