Provider Demographics
NPI:1790055036
Name:SEVER EFFECTIVENESS STRATEGIES INC
Entity Type:Organization
Organization Name:SEVER EFFECTIVENESS STRATEGIES INC
Other - Org Name:MARK SEVER PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SEVER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:707-887-0185
Mailing Address - Street 1:PO BOX 1483
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95436-1483
Mailing Address - Country:US
Mailing Address - Phone:707-887-0185
Mailing Address - Fax:707-887-1681
Practice Address - Street 1:6478 MIRABEL ROAD
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:CA
Practice Address - Zip Code:95436-1483
Practice Address - Country:US
Practice Address - Phone:707-887-0185
Practice Address - Fax:707-887-1681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11388261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy