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General NPI Number Information
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NPI Number | 1336262369
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Entity Type | Organization
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Legal Business Name | CAMARILLO AQUATICS AND PHYSICAL THERAPY SERVICES INC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 01/16/2013
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Provider Practice Location Address
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Address Line | 4960 VERDUGO WAY
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City | CAMARILLO
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State | CA
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Zip | 93012-8632
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Country | US
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Telephone | 805-384-8050
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Fax | 805-384-8550
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Provider Business Mailing Address
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Address Line | 4960 VERDUGO WAY
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City | CAMARILLO
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State | CA
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Zip | 93012-8632
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Country | US
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Telephone | 805-384-8050
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Fax | 805-384-8550
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. DAVID VINCENT POWERS
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Credential | P.T.
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Telephone | 310-871-8210
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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 |
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License Number State |
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