Healthcare Provider Details

I. General information

NPI: 1114166055
Provider Name (Legal Business Name): DYNAMIC THERAPIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E FOOTHILL BLVD STE. 100
ARCADIA CA
91006-2314
US

IV. Provider business mailing address

50 E FOOTHILL BLVD STE. 100
ARCADIA CA
91006-2314
US

V. Phone/Fax

Practice location:
  • Phone: 626-445-2400
  • Fax: 626-445-2419
Mailing address:
  • Phone: 626-445-2400
  • Fax: 626-445-2419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name: GISELE L STEPPUHN
Title or Position: OFFICE MANAGER
Credential:
Phone: 626-445-2400