Provider Demographics
NPI:1720206782
Name:HOLTVILLE THERAPY CENTER
Entity Type:Organization
Organization Name:HOLTVILLE THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:760-455-3306
Mailing Address - Street 1:110 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HOLTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92250-1214
Mailing Address - Country:US
Mailing Address - Phone:760-455-3306
Mailing Address - Fax:760-344-8240
Practice Address - Street 1:110 W 5TH ST
Practice Address - Street 2:
Practice Address - City:HOLTVILLE
Practice Address - State:CA
Practice Address - Zip Code:92250-1214
Practice Address - Country:US
Practice Address - Phone:760-455-3306
Practice Address - Fax:760-344-8240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy