Healthcare Provider Details

I. General information

NPI: 1003589516
Provider Name (Legal Business Name): BOUT2BEBETTER PHYSICAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 N 1ST AVE
ARCADIA CA
91006-3205
US

IV. Provider business mailing address

24 N 1ST AVE
ARCADIA CA
91006-3205
US

V. Phone/Fax

Practice location:
  • Phone: 626-228-4696
  • Fax: 626-348-8926
Mailing address:
  • Phone: 626-228-4696
  • Fax: 626-348-8926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER DUXBURY JOHNSON
Title or Position: OFFICER, OWNER
Credential: DRPH, PT, CSCS
Phone: 626-228-4696