Provider Demographics
NPI:1689691305
Name:ALPHA PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:ALPHA PHYSICAL THERAPY, INC
Other - Org Name:ALPHA PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSLADIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-276-4598
Mailing Address - Street 1:2292 ABBEYHILL RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-2902
Mailing Address - Country:US
Mailing Address - Phone:916-276-4598
Mailing Address - Fax:916-434-9722
Practice Address - Street 1:2292 ABBEYHILL RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-2902
Practice Address - Country:US
Practice Address - Phone:916-276-4598
Practice Address - Fax:916-434-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT280762251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA55-6530Medicare UPIN