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General NPI Number Information
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NPI Number | 1528871142
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Entity Type | Organization
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Legal Business Name | ETERNITY PHYSICAL THERAPY & WELLNESS, PC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 11650 MISSION PARK DR STE 114
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-9010
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Country | US
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Telephone | 909-662-5489
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Fax |
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Provider Business Mailing Address
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Address Line | 8605 SANTA MONICA BLVD PMB 968365
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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 |
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ASHLEY YVETTE PAZ
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Credential |
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Telephone | 909-565-7012
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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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