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General NPI Number Information
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NPI Number | 1386290013
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Entity Type | Organization
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Legal Business Name | PHYSIOFIXX IPT PHYSICAL THERAPY CORP
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 6475 ALVARADO RD STE 118
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City | SAN DIEGO
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State | CA
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Zip | 92120-5007
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Country | US
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Telephone | 858-342-9538
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Fax |
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Provider Business Mailing Address
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Address Line | 7429 STONEVIEW CT
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City | SAN DIEGO
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State | CA
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Zip | 92119-1212
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Country | US
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Telephone | 858-342-9538
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SANDRA L DANIEL
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Credential | PT, DPT, ,OCS
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Telephone | 858-342-9538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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