Provider Demographics
NPI:1730278748
Name:KERRY J. BESMEHN AND LOANNE RUBE PTR
Entity Type:Organization
Organization Name:KERRY J. BESMEHN AND LOANNE RUBE PTR
Other - Org Name:WEST VALLEY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:JAN
Authorized Official - Last Name:BESMEHN
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:408-253-4211
Mailing Address - Street 1:5150 GRAVES AVE
Mailing Address - Street 2:SUITE 11 D
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5013
Mailing Address - Country:US
Mailing Address - Phone:408-253-4211
Mailing Address - Fax:408-253-0915
Practice Address - Street 1:5150 GRAVES AVE
Practice Address - Street 2:SUITE 11 D
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-5013
Practice Address - Country:US
Practice Address - Phone:408-253-4211
Practice Address - Fax:408-253-0915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7080261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy