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General NPI Number Information
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NPI Number | 1295783520
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Entity Type | Organization
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Legal Business Name | BARBARA JEAN BOUTELLE/CARLSBAD PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 10/20/2008
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Provider Practice Location Address
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Address Line | 891 KUHN DR STE. 101
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City | CHULA VISTA
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State | CA
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Zip | 91914-3551
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Country | US
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Telephone | 619-656-6470
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Fax | 619-656-6614
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Provider Business Mailing Address
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Address Line | 600 S ANDREASEN DR STE C
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City | ESCONDIDO
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State | CA
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Zip | 92029-1917
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Country | US
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Telephone | 760-591-7750
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Fax | 760-294-9813
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Authorized Official
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Title or Position | OWNER/SECRETARY
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Name | MS. BARBARA JEAN BOUTELLE
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Credential | M.P.T.
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Telephone | 760-591-7750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251H1200X
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Taxonomy Name | Hand Physical Therapist
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State | CA
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Taxonomy #3
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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 | CA
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