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General NPI Number Information
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NPI Number | 1386266229
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Entity Type | Organization
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Legal Business Name | BRIDGE2PT PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 6862 IVY CREEK WAY
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City | MOORPARK
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State | CA
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Zip | 93021-5055
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Country | US
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Telephone | 714-878-4008
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Fax | 805-330-6568
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Provider Business Mailing Address
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Address Line | 6862 IVY CREEK WAY
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City | MOORPARK
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State | CA
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Zip | 93021-5055
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Country | US
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Telephone | 805-341-7496
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Fax | 805-330-6568
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Authorized Official
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Title or Position | CEO, CO-FOUNDER
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Name | COLLIN MCDONELL
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Credential | PT
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Telephone | 805-341-7496
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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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