Provider Demographics
NPI:1861717605
Name:WESTERN PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:WESTERN PHYSICAL THERAPY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST PT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:530-221-9952
Mailing Address - Street 1:PO BOX 493396
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-3396
Mailing Address - Country:US
Mailing Address - Phone:530-221-9952
Mailing Address - Fax:530-221-9954
Practice Address - Street 1:1495 VICTOR AVE
Practice Address - Street 2:SUITE D
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003
Practice Address - Country:US
Practice Address - Phone:530-221-9952
Practice Address - Fax:530-221-9954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty