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General NPI Number Information
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NPI Number | 1164439915
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Entity Type | Organization
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Legal Business Name | BODY AWARENESS PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 2951 HARBOR BLVD
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City | COSTA MESA
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State | CA
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Zip | 92626-3912
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Country | US
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Telephone | 714-546-7575
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Fax | 714-546-7573
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Provider Business Mailing Address
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Address Line | PO BOX 3871
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City | COSTA MESA
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State | CA
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Zip | 92628-3871
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Country | US
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Telephone | 714-546-7575
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Fax | 714-546-7573
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Authorized Official
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Title or Position | PRESIDENT/PHYSICAL THERAPIST
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Name | CHRISTENE MARIE MORGAN
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Credential | P.T.
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Telephone | 714-546-7575
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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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