Healthcare Provider Details

I. General information

NPI: 1407349798
Provider Name (Legal Business Name): MANES FOR MOVEMENT PHYSICAL THERAPY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WILDHORSE LN
ROLLING HILLS ESTATES CA
90274-1528
US

IV. Provider business mailing address

PO BOX 1587
TORRANCE CA
90505-0587
US

V. Phone/Fax

Practice location:
  • Phone: 310-737-2938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIN O'MAHONY
Title or Position: OWNER, DIRECTOR
Credential: PT, DPT
Phone: 310-737-2938