Provider Demographics
NPI:1295734788
Name:THRALL, STEVE ARNOLD (PT)
Entity type:Individual
Prefix:MR
First Name:STEVE
Middle Name:ARNOLD
Last Name:THRALL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 GREENBACK LANE
Mailing Address - Street 2:STE 100
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-6227
Mailing Address - Country:US
Mailing Address - Phone:916-723-3372
Mailing Address - Fax:916-723-1638
Practice Address - Street 1:6560 GREENBACK LANE
Practice Address - Street 2:STE 100
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-6227
Practice Address - Country:US
Practice Address - Phone:916-723-3372
Practice Address - Fax:916-723-1638
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT9913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ070872OtherBLUE SHIELD
CA0008158486OtherAETNA
CA0008158486OtherAETNA
CAZZZ070872OtherBLUE SHIELD