Provider Demographics
NPI:1659136273
Name:TRIPLE GLASS PHYSICAL THERAPY AND PERFORMANCE, INC.
Entity type:Organization
Organization Name:TRIPLE GLASS PHYSICAL THERAPY AND PERFORMANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:510-825-9668
Mailing Address - Street 1:2427 EUCLID PL
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5922
Mailing Address - Country:US
Mailing Address - Phone:510-825-9668
Mailing Address - Fax:
Practice Address - Street 1:2427 EUCLID PL
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5922
Practice Address - Country:US
Practice Address - Phone:510-825-9668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty