Healthcare Provider Details
I. General information
NPI: 1811811995
Provider Name (Legal Business Name): MADDUX MOVEMENT PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 MOBIL AVE STE A1
CAMARILLO CA
93010-6345
US
IV. Provider business mailing address
423 W LOOP DR
CAMARILLO CA
93010-2040
US
V. Phone/Fax
- Phone: 805-815-1738
- Fax:
- Phone: 805-815-1738
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRET
D
MADDUX
Title or Position: DIRECTOR, PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 805-815-1738