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General NPI Number Information
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NPI Number | 1831564756
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Entity Type | Organization
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Legal Business Name | MUV PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 5650 EL CAMINO REAL SUITE 120
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City | CARLSBAD
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State | CA
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Zip | 92008-7124
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Country | US
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Telephone | 760-919-2688
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Fax |
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Provider Business Mailing Address
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Address Line | 5650 EL CAMINO REAL SUITE 120
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City | CARLSBAD
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State | CA
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Zip | 92008-7124
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Country | US
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Telephone | 760-919-2688
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MOLLIE FITZSIMMONS
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Credential | P.T.
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Telephone | 714-222-0053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 24156
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License Number State | CA
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