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General NPI Number Information
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NPI Number | 1194759159
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Entity Type | Organization
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Legal Business Name | HARMON PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 1250 S SUNSET AVE #204
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City | WEST COVINA
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State | CA
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Zip | 91790-3961
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Country | US
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Telephone | 626-960-2853
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Fax | 626-856-5512
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Provider Business Mailing Address
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Address Line | 1250 S SUNSET AVE #204
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City | WEST COVINA
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State | CA
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Zip | 91790-3961
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Country | US
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Telephone | 626-960-2853
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Fax | 626-856-5512
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Authorized Official
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Title or Position | OWNER
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Name | MR. BUFORD KERSHAW HARMON III
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Credential | R.P.T.
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Telephone | 626-960-2853
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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 | PT5299
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License Number State | CA
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