Provider Demographics
NPI:1689986135
Name:INTEGRATED HEALTHCARE SERVICES PHYSICAL THERAPY NETWORK
Entity Type:Organization
Organization Name:INTEGRATED HEALTHCARE SERVICES PHYSICAL THERAPY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-627-3907
Mailing Address - Street 1:950 FEE ANA ST
Mailing Address - Street 2:#A
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-6755
Mailing Address - Country:US
Mailing Address - Phone:866-627-3907
Mailing Address - Fax:866-770-6589
Practice Address - Street 1:950 FEE ANA ST
Practice Address - Street 2:#A
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6755
Practice Address - Country:US
Practice Address - Phone:866-627-3907
Practice Address - Fax:866-770-6589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy