Provider Demographics
NPI:1962190413
Name:BUDDY & BEAR PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:BUDDY & BEAR PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAGNOLIA
Authorized Official - Middle Name:DELA CRUZ
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:915-920-6883
Mailing Address - Street 1:200 LOWELL CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-5464
Mailing Address - Country:US
Mailing Address - Phone:915-920-6883
Mailing Address - Fax:
Practice Address - Street 1:200 LOWELL CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-5464
Practice Address - Country:US
Practice Address - Phone:915-920-6883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty