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Objects / Healthcare Organization

Healthcare Organization Stored source record

PHYSICAL MEDICINE CTR OF MARIN, A PT CORP.

33 MILLER AVE, MILL VALLEY, CA, 949411903

atlas:atm_npi_1013176775

Block 1018Block Group 1Census Tract 1270Marin CountyCaliforniaUnited States

What is stored

phone
415-380-9242
status
A
address
33 MILLER AVE, MILL VALLEY, CA, 949411903
fax
415-388-7458
npi
1013176775
taxonomy
Physical Therapist
other names
[]
last updated
2008-06-06
taxonomy code
225100000X
all taxonomies
["Physical Therapist"]
enumeration date
2008-06-06
enumeration type
NPI-2
practice locations
0
authorized official
MICHAEL IACOVELLI
organizational subpart
NO

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{
  "fax": "415-388-7458",
  "npi": "1013176775",
  "phone": "415-380-9242",
  "status": "A",
  "address": "33 MILLER AVE, MILL VALLEY, CA, 949411903",
  "license": null,
  "taxonomy": "Physical Therapist",
  "other_names": [],
  "last_updated": "2008-06-06",
  "license_state": null,
  "taxonomy_code": "225100000X",
  "all_taxonomies": [
    "Physical Therapist"
  ],
  "enumeration_date": "2008-06-06",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "MICHAEL IACOVELLI",
  "organizational_subpart": "NO"
}