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General NPI Number Information
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NPI Number | 1427758762
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Entity Type | Organization
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Legal Business Name | NORA B, PT PEDIATRIC PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 11835 W OLYMPIC BLVD STE 925E
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City | LOS ANGELES
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State | CA
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Zip | 90064-5090
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Country | US
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Telephone | 917-755-8910
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Fax |
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Provider Business Mailing Address
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Address Line | 1233 20TH ST APT 4
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City | SANTA MONICA
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State | CA
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Zip | 90404-1310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELEANOR BACHMAN
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Credential | PT
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Telephone | 917-755-8910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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