Provider Demographics
NPI:1922647973
Name:VALLEY PHYSICAL THERAPY SOLUTIONS, INC.
Entity Type:Organization
Organization Name:VALLEY PHYSICAL THERAPY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GAMBOA
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-257-5283
Mailing Address - Street 1:2117 STARLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-0890
Mailing Address - Country:US
Mailing Address - Phone:217-257-5283
Mailing Address - Fax:
Practice Address - Street 1:2117 STARLIGHT DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95357-0890
Practice Address - Country:US
Practice Address - Phone:217-257-5283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-21
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy