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General NPI Number Information
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NPI Number | 1568202968
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Entity Type | Organization
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Legal Business Name | ELEONORA VINCE, PHYSICAL THERAPY INC.
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 171 SAXONY RD STE 207
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City | ENCINITAS
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State | CA
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Zip | 92024-6777
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Country | US
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Telephone | 760-206-3076
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Fax |
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Provider Business Mailing Address
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Address Line | 1811 AUTUMN PL
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City | ENCINITAS
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State | CA
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Zip | 92024-1961
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Country | US
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Telephone | 310-625-2275
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ELEONORA JOAN VINCE
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Credential | PT, DPT
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Telephone | 760-206-3076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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