Healthcare Provider Details
I. General information
NPI: 1093104333
Provider Name (Legal Business Name): COURY & BUEHLER PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2015
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24301 MUIRLANDS BLVD SUITE T
LAKE FOREST CA
92630-3627
US
IV. Provider business mailing address
3230 E IMPERIAL HWY STE 100
BREA CA
92821-6735
US
V. Phone/Fax
- Phone: 949-271-0012
- Fax: 949-271-0013
- Phone: 714-988-8113
- Fax: 714-988-8114
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
RICHARD
J
COURY
Title or Position: OWNER, CEO, CFO
Credential:
Phone: 714-256-5074