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General NPI Number Information
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NPI Number | 1205966520
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC HANDS ORTHOPEDIC HOME PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 11422 HOLLY FERN CT.
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City | SAN DIEGO
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State | CA
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Zip | 92131
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Country | US
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Telephone | 858-335-5658
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Fax | 858-578-5759
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Provider Business Mailing Address
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Address Line | 11422 HOLLY FERN CT.
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City | SAN DIEGO
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State | CA
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Zip | 92131
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Country | US
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Telephone | 858-335-5658
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Fax | 858-578-5759
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EYTAN EREZ
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Credential | PT
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Telephone | 858-335-5658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT21745
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License Number State | CA
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