Healthcare Provider Details

I. General information

NPI: 1720319692
Provider Name (Legal Business Name): IN TOUCH PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2010
Last Update Date: 01/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 E THOUSAND OAKS BLVD
THOUSAND OAKS CA
91362-2824
US

IV. Provider business mailing address

11224 BROADVIEW DR
MOORPARK CA
93021-3723
US

V. Phone/Fax

Practice location:
  • Phone: 805-551-0939
  • Fax:
Mailing address:
  • Phone: 805-551-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT10753
License Number StateCA

VIII. Authorized Official

Name: MRS. KATHY JANE JOHNSON
Title or Position: PRESIDENT
Credential: RPT
Phone: 805-551-0939