Provider Demographics
NPI:1386978765
Name:JH PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:JH PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:909-594-3949
Mailing Address - Street 1:1070 N BATAVIA ST
Mailing Address - Street 2:SUITE F-518
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5544
Mailing Address - Country:US
Mailing Address - Phone:949-228-2459
Mailing Address - Fax:
Practice Address - Street 1:1070 N BATAVIA ST
Practice Address - Street 2:SUITE F-518
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-5544
Practice Address - Country:US
Practice Address - Phone:949-228-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2013-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101602251G0304X
225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Single Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty