Provider Demographics
NPI:1245311950
Name:PHELPS & ASSOCIATES PHYSICAL THERAPY
Entity type:Organization
Organization Name:PHELPS & ASSOCIATES PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:G
Authorized Official - Last Name:PHELPS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:831-757-6834
Mailing Address - Street 1:102 SAN MIGUEL AVE
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3057
Mailing Address - Country:US
Mailing Address - Phone:831-757-6834
Mailing Address - Fax:831-757-9378
Practice Address - Street 1:102 SAN MIGUEL AVE
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3057
Practice Address - Country:US
Practice Address - Phone:831-757-6834
Practice Address - Fax:831-757-9378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ19494ZMedicare PIN