Physical Medicine Ctr of Marin, a Pt Corp.

NPI #1013176775 in Mill Valley, California

Provider Information

NPI Number: 1013176775
Entity Type: Organization
Organization Name: Physical Medicine Ctr of Marin, a Pt Corp.
Primary Specialty: Physical Therapist
Enumeration Date: Jun 6, 2008
Last Updated: Jun 6, 2008

Practice Location

Address: 33 MILLER AVE
City: Mill Valley
State: California
ZIP Code: 94941-1903
Phone: (415) 380-9242

Authorized Official

Name: MICHAEL JOSEPH IACOVELLI, PT, DC
Title: PRESIDENT, PHYSICAL THERAPIST
Phone: (415) 380-9242

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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