| NPI | 1669873782 |
|---|---|
| Doing Business As | PINE STREET PHYSICAL & OCCUPATIONAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | JOHN K BOB D PT / Owner / President 209-451-3920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225XH1200X Occupational Therapist, Hand |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |