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General NPI Number Information
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NPI Number | 1316256225
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Entity Type | Organization
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Legal Business Name | ADVANCED PHYSICAL THERAPY AND SPORTS MEDICINE
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 101 HODENCAMP RD STE 102
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5831
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Country | US
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Telephone | 805-496-9944
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Fax | 805-496-9945
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Provider Business Mailing Address
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Address Line | 2287 MOSS CT
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-1416
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Country | US
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Telephone | 818-326-9750
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Fax | 805-496-9945
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Authorized Official
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Title or Position | CFO
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Name | DR. CODY G JONES
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Credential | PT, DPT, OCS
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Telephone | 818-326-9750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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