Individual provider · Type 1 NPI

Theddy Trece Geronimo Grumo, PTA

Physical Therapy Assistant · Fresno, CA

NPI number 1104452267 Active

Practice location

5555 N Fresno St
Fresno, CA 93710-6006

Call (559) 430-8211 Map

Mailing address

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X50168 (CA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1104452267

Theddy Trece Geronimo Grumo, PTA's National Provider Identifier is 1104452267, issued on Mar 19, 2020. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Fresno, CA. The record was last updated on Mar 19, 2020.