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General NPI Number Information
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NPI Number | 1366995870
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Entity Type | Organization
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Legal Business Name | LEVEL 4 PHYSICAL THERAPY AND PERFORMANCE, INC.
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 171 SAXONY RD STE 105
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City | ENCINITAS
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State | CA
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Zip | 92024
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Country | US
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Telephone | 760-503-4440
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Fax | 801-409-2137
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Provider Business Mailing Address
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Address Line | 171 SAXONY RD STE 105
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City | ENCINITAS
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State | CA
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Zip | 92024-6776
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Country | US
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Telephone | 760-503-4440
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Fax | 801-409-2137
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Authorized Official
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Title or Position | VP
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Name | DAWN DIMITRIS ANDALON
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Credential | PT
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Telephone | 760-503-4440
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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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