Provider Demographics
NPI:1760097158
Name:HEALTHSTREAM PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:HEALTHSTREAM PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:KORSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-836-1155
Mailing Address - Street 1:9984 SCRIPPS RANCH BLVD STE 361
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1825
Mailing Address - Country:US
Mailing Address - Phone:858-836-1155
Mailing Address - Fax:858-715-8444
Practice Address - Street 1:3750 CONVOY ST STE 175
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-9739
Practice Address - Country:US
Practice Address - Phone:858-836-1155
Practice Address - Fax:858-715-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty