Provider Demographics
NPI:1760738090
Name:PLATZ, BARBARA (PHYS THER ASST)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:PLATZ
Suffix:
Gender:F
Credentials:PHYS THER ASST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 W MARCH LN STE 102
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-6424
Mailing Address - Country:US
Mailing Address - Phone:209-298-4907
Mailing Address - Fax:
Practice Address - Street 1:1625 W MARCH LN STE 102
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6424
Practice Address - Country:US
Practice Address - Phone:209-298-4907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT289225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant