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General NPI Number Information
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NPI Number | 1548502610
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Entity Type | Organization
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Legal Business Name | STABILIZE PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 881 DOVER DR SUITE 285
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-5962
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Country | US
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Telephone | 949-631-3321
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Fax |
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Provider Business Mailing Address
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Address Line | 881 DOVER DR SUITE 285
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-5962
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Country | US
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Telephone | 949-631-3321
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LAURA C. GORHAM
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Credential | PT, MPT
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Telephone | 949-631-3321
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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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