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General NPI Number Information
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NPI Number | 1598898637
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Entity Type | Organization
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Legal Business Name | THER EX, INC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23356 TIMBERLANE DR
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City | VALENCIA
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State | CA
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Zip | 91354-1450
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Country | US
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Telephone | 661-513-9317
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Fax | 661-513-9348
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Provider Business Mailing Address
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Address Line | 23356 TIMBERLANE DR
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City | VALENCIA
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State | CA
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Zip | 91354-1450
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Country | US
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Telephone | 661-513-9317
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Fax | 661-513-9348
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. MARC LEVINE
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Credential | RPT
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Telephone | 661-513-9317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | PT 16807
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License Number State | CA
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