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General NPI Number Information
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NPI Number | 1043091028
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Entity Type | Organization
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Legal Business Name | PERFORM & RESTORE PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/06/2023
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 431 S HEWITT ST
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City | LOS ANGELES
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State | CA
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Zip | 90013-2215
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Country | US
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Telephone | 323-818-0345
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Fax |
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Provider Business Mailing Address
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Address Line | 6432 E LOS ARCOS ST
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City | LONG BEACH
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State | CA
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Zip | 90815-2344
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | JUDY ZHOU
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Credential |
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Telephone | 206-883-3876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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