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General NPI Number Information
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NPI Number | 1770820177
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Entity Type | Organization
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Legal Business Name | MOBILE SOLUTIONS PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 14 ORANGE BLOSSOM CIR
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City | LADERA RANCH
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State | CA
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Zip | 92694-1250
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Country | US
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Telephone | 949-683-1661
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Fax | 949-954-4206
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Provider Business Mailing Address
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Address Line | 14 ORANGE BLOSSOM CIR
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City | LADERA RANCH
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State | CA
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Zip | 92694-1250
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Country | US
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Telephone | 949-683-1661
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Fax | 949-954-4206
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DAVID SEAN LUXENBERG
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Credential | PT, DPT, CSCS
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Telephone | 949-683-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT38419
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License Number State | CA
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