Provider Demographics
NPI:1790115376
Name:MCCARTHY'S INTERACTIVE PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:MCCARTHY'S INTERACTIVE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, GCS
Authorized Official - Phone:415-665-4953
Mailing Address - Street 1:927 VICENTE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-3023
Mailing Address - Country:US
Mailing Address - Phone:415-665-4953
Mailing Address - Fax:415-665-4953
Practice Address - Street 1:927 VICENTE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-3023
Practice Address - Country:US
Practice Address - Phone:415-665-4953
Practice Address - Fax:415-665-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252702251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty