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General NPI Number Information
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NPI Number | 1780808550
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY & SPORT INJURY REHABILITATION CENTER OF ENCINO
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 16311 VENTURA BLVD SUITE 955
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City | ENCINO
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State | CA
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Zip | 91436-2124
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Country | US
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Telephone | 818-789-4465
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Fax | 818-789-0279
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Provider Business Mailing Address
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Address Line | 16311 VENTURA BLVD SUITE 955
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City | ENCINO
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State | CA
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Zip | 91436-2124
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Country | US
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Telephone | 818-789-4465
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Fax | 818-789-0279
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | SHIRLEY F SARCHAD
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Credential | RPT
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Telephone | 818-789-4465
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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 | PT10218
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License Number State | CA
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