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NPI 1215090048 - Physical Therapist - 2251P0200X

NPI Details
NPI 1215090048
Enumeration Date 12/19/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name AMY AMY
Position OWNER
Phone (310) 426-9406
Fax
Practice Location
150 SIERRA ST
EL SEGUNDO CA, 90245-4117, US
Phone (310) 426-9406
Fax
Business Location
150 SIERRA ST
EL SEGUNDO CA, 90245-4117, US
Phone
Fax
Toxanomy
Taxonomy Code 2251P0200X
License State California
License Number 26382
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According to our database, The Starting Block NPI is 1215090048, taxonomy code is 2251P0200X and license number is 26382, license state is located at California. The Starting Block physically located at 150 Sierra St, El Segundo CA, 90245-4117. NPI Number 1033115704 has the healthcare provider type.

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1215090048 NPI number is provided on an as is basis without warranty of any kind. 1215090048 is maintained by the National Plan & Provider Enumeration System. The contents of The Starting Block are for informational purposes only.