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General NPI Number Information
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NPI Number | 1093773640
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Entity Type | Organization
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Legal Business Name | LAGUNA HILLS PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 25431 CABOT RD STE 101
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5526
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Country | US
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Telephone | 949-830-6220
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Fax | 949-830-6227
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Provider Business Mailing Address
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Address Line | 25431 CABOT RD STE 101
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5526
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Country | US
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Telephone | 949-830-6220
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Fax | 949-830-6227
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Authorized Official
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Title or Position | PHYSICAL THERAPIST OWNER
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Name | MISS SUSAN PRATT
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Credential | MPT
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Telephone | 949-830-6220
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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 | PT25877
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License Number State | CA
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