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General NPI Number Information
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NPI Number | 1316428048
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Entity Type | Organization
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Legal Business Name | ACCESS ORTHOPEDIC PHYSICAL THERAPY AND CONDITIONING INC.
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 546 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5304
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Country | US
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Telephone | 714-257-5551
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Fax | 562-320-5167
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Provider Business Mailing Address
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Address Line | 546 S BREA BLVD
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City | BREA
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State | CA
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Zip | 92821-5304
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Country | US
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Telephone | 714-257-5551
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Fax | 562-320-5167
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | TAE HO LEE
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Credential | PHYSICAL THERAPIST
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Telephone | 714-257-5551
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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 | 34285
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License Number State | CA
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