Provider Demographics
NPI:1942498977
Name:UPPER MARKET SPORT AND SPINE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:UPPER MARKET SPORT AND SPINE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LOWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATTOLICO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:415-593-2532
Mailing Address - Street 1:3727 BUCHANAN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-5410
Mailing Address - Country:US
Mailing Address - Phone:415-593-2532
Mailing Address - Fax:415-593-7974
Practice Address - Street 1:2191 MARKET ST
Practice Address - Street 2:SUITE C
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1399
Practice Address - Country:US
Practice Address - Phone:415-861-1856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN FRANCISCO SPORT AND SPINE PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty