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General NPI Number Information
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NPI Number | 1073142741
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Entity Type | Organization
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Legal Business Name | AEON PHYSICAL THERAPY CORP
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Dates
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Enumeration Date | 04/05/2020
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 175 W LA VERNE AVE STE A
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City | POMONA
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State | CA
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Zip | 91767-2347
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Country | US
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Telephone | 909-741-7690
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Fax |
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Provider Business Mailing Address
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Address Line | 175 W LA VERNE AVE STE A
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City | POMONA
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State | CA
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Zip | 91767-2347
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Country | US
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Telephone | 909-741-7690
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. YU-CHING HUANG
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Credential | PHYSICAL THERAPIST
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Telephone | 909-741-7690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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