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General NPI Number Information
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NPI Number | 1700199106
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Entity Type | Organization
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Legal Business Name | WELLNESS RX PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 23721 CALLE GANADOR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-3228
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Country | US
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Telephone | 949-306-3602
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Fax |
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Provider Business Mailing Address
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Address Line | 23721 CALLE GANADOR
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City | MISSION VIEJO
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State | CA
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Zip | 92691-3228
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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 | PRESIDENT
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Name | MR. CHRISTOPHER MARC ACKERMAN
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Credential | D.P.T., P.C.S.
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Telephone | 949-306-3602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 27505
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 27505
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License Number State | CA
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