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General NPI Number Information
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NPI Number | 1437724820
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Entity Type | Organization
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Legal Business Name | COMBAT PHYSICAL AND OCCUPATIONAL THERAPY , INC.
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 3919 NORMAL ST APT 206
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City | SAN DIEGO
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State | CA
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Zip | 92103-3463
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Country | US
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Telephone | 412-952-9726
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 MARKET ST # 190
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City | SAN DIEGO
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State | CA
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Zip | 92101-7233
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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 | PHYSICAL AND OCCUPATIONAL THERAPIST
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Name | GINA CORNACCHIONE
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Credential | OTR/L, DPT
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Telephone | 412-952-9726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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