| Mina Park, | |
|
844 Bridge St Ste C, Colusa, CA 95932-2867 | |
| (530) 458-7770 | |
| (530) 458-7735 |
| Full Name | Mina Park |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 844 Bridge St Ste C, Colusa, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285411405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Primary |
| Provider Name | Western Physical Therapy Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1740216332 PECOS PAC ID: 8022076348 Enrollment ID: O20050103000515 |
| Mailing Address | Practice Location Address |
|---|---|
| Mina Park, 1495 Victor Ave Ste A, Redding, CA 96003-4093 Ph: (530) 221-9952 | Mina Park, 844 Bridge St Ste C, Colusa, CA 95932-2867 Ph: (530) 458-7770 |
Matthew Boyd Bennion, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 844 Bridge St, Suite C, Colusa, CA 95932 Phone: 530-458-7770 Fax: 530-458-7735 | |
Western Physical Therapy, Inc. Physical Therapist Medicare: Medicare Enrolled Practice Location: 844 Bridge St, Suite C, Colusa, CA 95932 Phone: 530-458-7770 Fax: 530-458-7735 | |
Christina Garcia Hayes, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 706 Jay St, Colusa, CA 95932 Phone: 530-458-4578 |