Provider Demographics
NPI:1902109671
Name:INTEGRATED PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:INTEGRATED PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPTA
Authorized Official - Phone:541-882-4612
Mailing Address - Street 1:2345 BIEHN ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1761
Mailing Address - Country:US
Mailing Address - Phone:541-882-4612
Mailing Address - Fax:541-273-2908
Practice Address - Street 1:2345 BIEHN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1761
Practice Address - Country:US
Practice Address - Phone:541-882-4612
Practice Address - Fax:541-273-2908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty