Provider Demographics
NPI:1841431020
Name:PLUCKHAN, PIPER DAWN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:PIPER
Middle Name:DAWN
Last Name:PLUCKHAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7888 WREN AVE
Mailing Address - Street 2:SUITE D-140
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-4962
Mailing Address - Country:US
Mailing Address - Phone:408-848-2225
Mailing Address - Fax:408-842-6700
Practice Address - Street 1:7888 WREN AVE
Practice Address - Street 2:SUITE D-140
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-4962
Practice Address - Country:US
Practice Address - Phone:408-848-2225
Practice Address - Fax:408-842-6700
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23508225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist