Healthcare Provider Details

I. General information

NPI: 1982651535
Provider Name (Legal Business Name): MANUAL ORTHOPEDIC PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 CANARIOS CT STE 110
CHULA VISTA CA
91910-7877
US

IV. Provider business mailing address

885 CANARIOS CT STE 110
CHULA VISTA CA
91910-7877
US

V. Phone/Fax

Practice location:
  • Phone: 619-656-5102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL STEIN
Title or Position: PRESIDENT
Credential: PT
Phone: 619-656-5102