1346334513 NPI number — DUEKER FEE PHYSICAL THERAPY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346334513 NPI number — DUEKER FEE PHYSICAL THERAPY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUEKER FEE PHYSICAL THERAPY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346334513
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7275 N 1ST ST
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93720-2977
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-439-8151
Provider Business Mailing Address Fax Number:
559-439-8154

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7275 N 1ST ST
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93720-2977
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-439-8151
Provider Business Practice Location Address Fax Number:
559-439-8154
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DUERKER
Authorized Official First Name:
ERIN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
559-439-8151

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT23374 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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