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General NPI Number Information
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NPI Number | 1275152407
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Entity Type | Organization
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Legal Business Name | NEW VISIONS PEDIATRIC THERAPY, INC
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 650 COMMERCE AVE STE E
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City | PALMDALE
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State | CA
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Zip | 93551-3884
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Country | US
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Telephone | 818-602-5163
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Fax | 661-252-2513
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Provider Business Mailing Address
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Address Line | 650 COMMERCE AVE STE E
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City | PALMDALE
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State | CA
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Zip | 93551-3884
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Country | US
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Telephone | 818-602-5163
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Fax | 661-252-2513
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Authorized Official
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Title or Position | DIRECTOR
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Name | JUAN FEDERICO DURAN
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Credential | PHYSICAL THERAPIST
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Telephone | 818-602-5163
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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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