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General NPI Number Information
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NPI Number | 1508653262
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Entity Type | Organization
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Legal Business Name | ATHLOS PHYSICAL THERAPY AND FITNESS, PC
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 7522 FOUNTAIN AVE
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-4104
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Country | US
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Telephone | 808-375-0733
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Fax |
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Provider Business Mailing Address
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Address Line | 8605 SANTA MONICA BLVD # 962586
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4109
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Country | US
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Telephone | 213-375-0460
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN TONG
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Credential | PT, DPT, OCS
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Telephone | 213-375-0460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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