Provider Demographics
NPI:1265569396
Name:PARROTT ASSOCIATES PHYSTHERAP
Entity type:Organization
Organization Name:PARROTT ASSOCIATES PHYSTHERAP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:PARROTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-548-0662
Mailing Address - Street 1:201 E ORANGEBURG AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5355
Mailing Address - Country:US
Mailing Address - Phone:209-548-0662
Mailing Address - Fax:209-548-0663
Practice Address - Street 1:201 E ORANGEBURG AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5355
Practice Address - Country:US
Practice Address - Phone:209-548-0662
Practice Address - Fax:209-548-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18810261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29650ZMedicare PIN