OLYMPIC PHYSICAL THERAPY

1 BLACKFIELD DR, TIBURON, CA, 949202053

atlas:atm_npi_1265523609

What is stored

phone: 415-383-6789
status: A
address: 1 BLACKFIELD DR, TIBURON, CA, 949202053
fax: 415-383-6744
npi: 1265523609
license: PT20057
taxonomy: Physical Therapist
other names: []
last updated: 2008-09-18
license state: CA
taxonomy code: 225100000X
all taxonomies: ["Physical Therapist"]
enumeration date: 2006-09-28
enumeration type: NPI-2
practice locations: 0
authorized official: JEFF HARBAND
organizational subpart: NO

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{
  "fax": "415-383-6744",
  "npi": "1265523609",
  "phone": "415-383-6789",
  "status": "A",
  "address": "1 BLACKFIELD DR, TIBURON, CA, 949202053",
  "license": "PT20057",
  "taxonomy": "Physical Therapist",
  "other_names": [],
  "last_updated": "2008-09-18",
  "license_state": "CA",
  "taxonomy_code": "225100000X",
  "all_taxonomies": [
    "Physical Therapist"
  ],
  "enumeration_date": "2006-09-28",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "JEFF HARBAND",
  "organizational_subpart": "NO"
}