Provider Demographics
NPI:1710995840
Name:WESTERN PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:WESTERN PHYSICAL THERAPY, INC.
Other - Org Name:LIVE OAK PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-221-9952
Mailing Address - Street 1:PO BOX 493396
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-3396
Mailing Address - Country:US
Mailing Address - Phone:530-221-9952
Mailing Address - Fax:530-221-9954
Practice Address - Street 1:10255 LIVE OAK BLVD
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:CA
Practice Address - Zip Code:95953-2015
Practice Address - Country:US
Practice Address - Phone:530-695-3700
Practice Address - Fax:530-695-3780
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTERN PHYSICAL THERAPY , INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-04
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty