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General NPI Number Information
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NPI Number | 1457154189
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Entity Type | Organization
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Legal Business Name | WHOLENESSRX PHYSICAL THERAPY CORPORATION
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 8305 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90069-1515
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Country | US
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Telephone | 310-818-8712
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Fax |
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Provider Business Mailing Address
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Address Line | 14220 WILLAMETTE AVE
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City | CHINO
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State | CA
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Zip | 91710-1121
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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 THERAPIST
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Name | DR. AMANDA CHAN
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Credential | DPT
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Telephone | 202-420-8771
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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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