Provider Demographics
NPI:1952788036
Name:PRECISION REHABILITATION & ORTHOPEDIC PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PRECISION REHABILITATION & ORTHOPEDIC PHYSICAL THERAPY
Other - Org Name:PRO-PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARSHOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-713-6806
Mailing Address - Street 1:368 W OLIVE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-3318
Mailing Address - Country:US
Mailing Address - Phone:559-782-1501
Mailing Address - Fax:559-782-8528
Practice Address - Street 1:4930 W KAWEAH CT
Practice Address - Street 2:203
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8324
Practice Address - Country:US
Practice Address - Phone:559-713-6806
Practice Address - Fax:559-713-6809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPT05004623A2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty