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General NPI Number Information
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NPI Number | 1336154301
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Entity Type | Organization
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Legal Business Name | M DREW VON POHLE PHYSICAL THERAPY A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 637 3RD AVE SUITE H
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City | CHULA VISTA
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State | CA
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Zip | 91910-5707
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Country | US
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Telephone | 619-422-0145
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Fax | 619-422-3121
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Provider Business Mailing Address
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Address Line | 637 3RD AVE SUITE H
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City | CHULA VISTA
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State | CA
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Zip | 91910-5707
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Country | US
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Telephone | 619-422-0145
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Fax | 619-422-3121
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. M DREW VON POHLE
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Credential | RPT
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Telephone | 619-422-0145
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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 | PT10015
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License Number State | CA
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