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General NPI Number Information
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NPI Number | 1518462514
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Entity Type | Organization
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Legal Business Name | PERSONALIZED PHYSICAL THERAPY & WELLNESS
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 10542 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2332
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Country | US
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Telephone | 310-837-8001
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 641654
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City | LOS ANGELES
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State | CA
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Zip | 90064-6654
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Country | US
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Telephone | 818-264-6534
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Fax |
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Authorized Official
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Title or Position | OWNER/PT
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Name | CHRISTOPHER TOLOS
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Credential | PT
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Telephone | 310-837-8001
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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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