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General NPI Number Information
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NPI Number | 1295970622
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Entity Type | Organization
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Legal Business Name | FOUNDATION PILATES
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 1131 MONTANA AVE
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City | SANTA MONICA
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State | CA
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Zip | 90403-1609
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Country | US
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Telephone | 310-260-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 MONTANA AVE
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City | SANTA MONICA
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State | CA
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Zip | 90403-1609
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Country | US
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Telephone | 310-260-1177
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAUL LLOYD ABBOTT
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Credential |
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Telephone | 310-699-0104
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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 | 136748
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License Number State | CA
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