Healthcare Provider Details

I. General information

NPI: 1033356597
Provider Name (Legal Business Name): KIDS IN MOTION PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3460 TORRANCE BLVD STE 100
TORRANCE CA
90503-5812
US

IV. Provider business mailing address

3460 TORRANCE BLVD STE 100
TORRANCE CA
90503-5812
US

V. Phone/Fax

Practice location:
  • Phone: 310-371-8555
  • Fax: 310-371-4488
Mailing address:
  • Phone: 310-371-8555
  • Fax: 310-371-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT24436
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT7841
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP19214
License Number StateCA

VIII. Authorized Official

Name: DR. MARCIE H RHEE
Title or Position: DIRECTOR/ OWNER
Credential: DPT, PCS
Phone: 310-371-8555