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General NPI Number Information
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NPI Number | 1790365997
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Entity Type | Organization
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Legal Business Name | MAKE WELL
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 369 SAN MIGUEL DR STE 370
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7847
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Country | US
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Telephone | 949-415-4820
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Fax |
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Provider Business Mailing Address
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Address Line | 20 SAINTSBURY
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City | IRVINE
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State | CA
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Zip | 92602-2435
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Country | US
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Telephone | 231-649-1288
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER
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Name | DR. LINDY LOUISE JOHNSON
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Credential | DPT
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Telephone | 231-649-1288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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