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General NPI Number Information
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NPI Number | 1780064162
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Entity Type | Organization
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Legal Business Name | IMPACT INJURY PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 09/18/2022
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Provider Practice Location Address
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Address Line | 2944 SANTA CARLOTTA ST
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City | LA CRESCENTA
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State | CA
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Zip | 91214-2022
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Country | US
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Telephone | 818-389-8997
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Fax |
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Provider Business Mailing Address
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Address Line | 2944 SANTA CARLOTTA ST
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City | LA CRESCENTA
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State | CA
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Zip | 91214-2022
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Country | US
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Telephone | 818-389-8997
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | NARBEH EMIN YERMIAN
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Credential | R.P.T.
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Telephone | 818-389-8997
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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 | PT41720
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License Number State | CA
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