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General NPI Number Information
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NPI Number | 1093158586
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Entity Type | Organization
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Legal Business Name | EXOS - ATHLETES' PERFORMANCE SAN DIEGO
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 2081 FARADAY AVE
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City | CARLSBAD
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State | CA
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Zip | 92008-7230
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Country | US
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Telephone | 760-494-1570
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Fax | 480-659-6305
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Provider Business Mailing Address
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Address Line | 2081 FARADAY AVE
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City | CARLSBAD
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State | CA
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Zip | 92008-7230
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Country | US
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Telephone | 760-494-1570
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Fax | 480-659-6305
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Authorized Official
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Title or Position | DIRECTOR, PHYSICAL THERAPY
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Name | MS. SHERI WALTERS
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Credential |
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Telephone | 480-626-4589
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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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