Provider Demographics
NPI:1316291503
Name:AUBURN ORTHOPEDIC & SPORTS PHYSICAL
Entity type:Organization
Organization Name:AUBURN ORTHOPEDIC & SPORTS PHYSICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:530-885-3940
Mailing Address - Street 1:11879 KEMPER RD STE 4
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-9021
Mailing Address - Country:US
Mailing Address - Phone:530-885-3940
Mailing Address - Fax:530-885-3984
Practice Address - Street 1:11879 KEMPER RD.
Practice Address - Street 2:SUITE 4
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-885-3940
Practice Address - Fax:530-885-3984
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUBURN ORTHOPEDIC & SPORTS PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-09
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty