Provider Demographics
NPI:1801946512
Name:CHINO PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:CHINO PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:II
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:909-628-9612
Mailing Address - Street 1:12421 CENTRAL AVE
Mailing Address - Street 2:SUITE A AND B
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2664
Mailing Address - Country:US
Mailing Address - Phone:909-628-9612
Mailing Address - Fax:909-591-9942
Practice Address - Street 1:12421 CENTRAL AVE
Practice Address - Street 2:SUITE A AND B
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2664
Practice Address - Country:US
Practice Address - Phone:909-628-9612
Practice Address - Fax:909-591-9942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty