| Alta Vista Healthcare Center | |
|
1123 N Main Ave Suite 100 San Antonio TX 78212-4740 | |
| (210) 822-6323 | |
| (210) 822-6356 |
| Full Name | Alta Vista Healthcare Center |
|---|---|
| Speciality | Physical Therapist |
| Location | 1123 N Main Ave, San Antonio, Texas |
| Authorized Official Name and Position | Phil Bohart (COOWNER) |
| Authorized Official Contact | 2108226323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta Vista Healthcare Center Po Box 600324 Dallas TX 75360-0324 Ph: (210) 822-6323 | Alta Vista Healthcare Center 1123 N Main Ave Suite 100 San Antonio TX 78212-4740 Ph: (210) 822-6323 |
| NPI Number | 1366588444 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366588444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 15980 (Texas) | Primary |
| 225100000X | Physical Therapist | 1038107 (Texas) | Primary |
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