Provider Demographics
NPI:1689065997
Name:WARRIOR PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:WARRIOR PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHNECKENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:626-755-4260
Mailing Address - Street 1:345 S LAKE AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-5030
Mailing Address - Country:US
Mailing Address - Phone:626-755-4260
Mailing Address - Fax:626-387-7737
Practice Address - Street 1:345 S LAKE AVE
Practice Address - Street 2:STE 201
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-5030
Practice Address - Country:US
Practice Address - Phone:626-755-4260
Practice Address - Fax:626-387-7737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA24463OtherSTATE LICENSE