| Clear Lake Physical Therapy Inc | |
|
14855 Olympic Dr, Clearlake, CA 95422-9522 | |
| (707) 994-7248 | |
| (707) 994-7248 |
| Full Name | Clear Lake Physical Therapy Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 14855 Olympic Dr, Clearlake, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477502912 | NPI | - | NPPES |
| GPT001040 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT17230 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Lake Physical Therapy Inc 14855 Olympic Dr, Po Box 3288, Clearlake, CA 95422-9522 Ph: (707) 994-7248 | Clear Lake Physical Therapy Inc 14855 Olympic Dr, Clearlake, CA 95422-9522 Ph: (707) 994-7248 |
Nyssa Rosina Midden, Physical Therapist Medicare: Medicare Enrolled Practice Location: 14855 Olympic Dr, Clearlake, CA 95422 Phone: 707-995-4888 | |
Marilyn Jean Hill, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3805 Dexter Ln, Clearlake, CA 95422 Phone: 707-994-7738 Fax: 707-994-7769 | |
Sarah Veseling, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 14855 Olympic Dr, Clearlake, CA 95422 Phone: 707-994-7248 | |
Janice Warne, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3805 Dexter Ln, Clearlake, CA 95422 Phone: 707-996-7738 |