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General NPI Number Information
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NPI Number | 1093089310
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Entity Type | Organization
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Legal Business Name | DYNAMIC PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/05/2012
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 1100 N 2ND ST # 1116
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City | EL CAJON
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State | CA
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Zip | 92021-5008
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Country | US
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Telephone | 619-444-5917
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Fax | 619-444-1740
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Provider Business Mailing Address
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Address Line | 1100 N 2ND ST # 1116
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City | EL CAJON
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State | CA
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Zip | 92021-5008
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Country | US
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Telephone | 619-444-5917
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Fax | 619-444-1740
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL BIGGS
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Credential |
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Telephone | 619-444-5917
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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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