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General NPI Number Information
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NPI Number | 1417652892
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Entity Type | Organization
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Legal Business Name | PRITZLPT LLC
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Dates
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Enumeration Date | 04/04/2023
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 31952 DEL OBISPO ST STE 200
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-3124
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Country | US
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Telephone | 949-240-1016
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Fax |
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Provider Business Mailing Address
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Address Line | 31952 DEL OBISPO ST STE 200
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City | SAN JUAN CAPISTRANO
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State | CA
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Zip | 92675-3124
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Country | US
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Telephone | 949-240-1016
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK J PRITZL
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Credential | PT
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Telephone | 949-240-1016
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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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