Healthcare Provider Details

I. General information

NPI: 1851347686
Provider Name (Legal Business Name): EGGLETON & LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 02/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2536 ROCKWOOD AVE
CALEXICO CA
92231-4407
US

IV. Provider business mailing address

317 N EL CAMINO REAL #210
ENCINITAS CA
92024-2811
US

V. Phone/Fax

Practice location:
  • Phone: 760-768-3422
  • Fax: 760-768-8408
Mailing address:
  • Phone: 760-634-0248
  • Fax: 760-634-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SEAN MICHAEL MCKEOWN
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 619-295-3000