Provider Demographics
NPI:1184771214
Name:SAVINA KOLLMORGEN & MARIA KATZ PHYSICAL THERAPIST PROF CORP
Entity type:Organization
Organization Name:SAVINA KOLLMORGEN & MARIA KATZ PHYSICAL THERAPIST PROF CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAVINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOLLMORGEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:818-343-3900
Mailing Address - Street 1:5525 ETIWANDA AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3647
Mailing Address - Country:US
Mailing Address - Phone:818-343-3900
Mailing Address - Fax:818-342-8545
Practice Address - Street 1:5525 ETIWANDA AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3647
Practice Address - Country:US
Practice Address - Phone:818-343-3900
Practice Address - Fax:818-342-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty