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General NPI Number Information
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NPI Number | 1073542064
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Entity Type | Organization
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Legal Business Name | LIFELONG MOBILITY, INC.
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3040 STATE ST STE F
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City | SANTA BARBARA
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State | CA
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Zip | 93105-3358
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Country | US
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Telephone | 805-687-4464
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Fax | 805-687-4496
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Provider Business Mailing Address
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Address Line | 3040 STATE ST STE F
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City | SANTA BARBARA
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State | CA
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Zip | 93105-3358
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Country | US
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Telephone | 805-687-4464
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Fax | 805-687-4496
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL ANTHONY MOCNY
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Credential | P. T.
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Telephone | 805-687-4464
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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 | CA
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