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General NPI Number Information
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NPI Number | 1194877159
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Entity Type | Organization
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Legal Business Name | ACTIVE CARE PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 4201 TORRANCE BLVD SUITE 200
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City | TORRANCE
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State | CA
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Zip | 90503-4504
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Country | US
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Telephone | 310-543-4727
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Fax | 310-543-0567
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Provider Business Mailing Address
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Address Line | 4201 TORRANCE BLVD SUITE 200
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City | TORRANCE
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State | CA
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Zip | 90503-4504
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Country | US
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Telephone | 310-543-4727
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Fax | 310-543-0567
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ELIZABETH Z UNDERHILL
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Credential | M.P.T.
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Telephone | 310-543-4727
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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 | PT20745
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License Number State | CA
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