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General NPI Number Information
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NPI Number | 1659827632
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR PRECISION IN MOVEMENT
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 394 COMMERCIAL RD
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3708
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Country | US
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Telephone | 909-747-9347
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Fax |
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Provider Business Mailing Address
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Address Line | 394 COMMERCIAL RD
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3708
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Country | US
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Telephone | 909-747-9347
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETER CHRISTOPHER LINGAS
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Credential | DPT
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Telephone | 707-339-0711
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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 | PT37158
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License Number State | CA
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