| Headwaters Medical Therapy Unit | |
|
1355 Industrial Ave Petaluma CA 94952-6500 | |
| (707) 565-8188 | |
| (707) 565-8190 |
| Full Name | Headwaters Medical Therapy Unit |
|---|---|
| Speciality | Clinic/center |
| Location | 1355 Industrial Ave, Petaluma, California |
| Authorized Official Name and Position | Ruby Zhang (DEPARTMENT ANALYST) |
| Authorized Official Contact | 7075657846 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Headwaters Medical Therapy Unit 1355 Industrial Ave Petaluma CA 94952-6500 Ph: (707) 565-8188 | Headwaters Medical Therapy Unit 1355 Industrial Ave Petaluma CA 94952-6500 Ph: (707) 565-8188 |
| NPI Number | 1427563261 |
|---|---|
| Provider Enumeration Date | 12/01/2017 |
| Last Update Date | 05/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427563261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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