Healthcare Provider Details
I. General information
NPI: 1902442353
Provider Name (Legal Business Name): UFIT PHYSICAL THERAPY ENTERPRISE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2019
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11 ROCK SPRINGS WAY
AZUSA CA
91702-6270
US
IV. Provider business mailing address
11 ROCK SPRINGS WAY
AZUSA CA
91702-6270
US
V. Phone/Fax
- Phone: 909-570-7787
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
YURONG
LU
Title or Position: OWNER/ DIRECTOR/ PHYSICAL THERAPIST
Credential: DPT, OCS
Phone: 909-570-7787