Provider Demographics
NPI:1962638338
Name:FIVE POINT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:FIVE POINT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:909-594-3943
Mailing Address - Street 1:20265 VALLEY BLVD
Mailing Address - Street 2:SUITE #O
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2654
Mailing Address - Country:US
Mailing Address - Phone:909-594-3943
Mailing Address - Fax:909-594-3951
Practice Address - Street 1:20265 VALLEY BLVD
Practice Address - Street 2:SUITE #O
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-2654
Practice Address - Country:US
Practice Address - Phone:909-594-3943
Practice Address - Fax:909-594-3951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty