Provider Demographics
NPI:1346056561
Name:SALMON FALLS PHYSICAL THERAPY PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SALMON FALLS PHYSICAL THERAPY PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LASALLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:916-824-5368
Mailing Address - Street 1:31 NATOMA ST STE 110
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2658
Mailing Address - Country:US
Mailing Address - Phone:916-824-5368
Mailing Address - Fax:
Practice Address - Street 1:31 NATOMA ST STE 110
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2658
Practice Address - Country:US
Practice Address - Phone:916-824-5368
Practice Address - Fax:916-579-6190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy