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General NPI Number Information
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NPI Number | 1356667828
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Entity Type | Organization
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Legal Business Name | ATTIKEN PHYSICAL THERAPY
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | 715 AVOCADO AVE
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-1938
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Country | US
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Telephone | 949-375-6761
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Fax |
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Provider Business Mailing Address
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Address Line | 715 AVOCADO AVE
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-1938
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Country | US
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Telephone | 949-375-6761
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | CHRISTINA ATTIKEN
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Credential | MPT
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Telephone | 949-375-6761
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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 | PT24596
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License Number State | CA
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