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General NPI Number Information
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NPI Number | 1144085150
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY SAN PEDRO CORP.
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 481 W 6TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90731-2631
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Country | US
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Telephone | 424-536-3023
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Fax | 424-536-3093
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Provider Business Mailing Address
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Address Line | 481 W 6TH ST
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City | SAN PEDRO
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State | CA
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Zip | 90731-2631
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Country | US
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Telephone | 424-536-3023
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | DR. JANAE NICOLE BROWN
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Credential | PT, DPT
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Telephone | 424-536-3023
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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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