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General NPI Number Information
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NPI Number | 1841582756
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Entity Type | Organization
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Legal Business Name | TEMECULA VALLEY PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 05/11/2011
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Provider Practice Location Address
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Address Line | 36058 JOLTAIRE WAY
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City | WINCHESTER
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State | CA
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Zip | 92596-8741
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Country | US
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Telephone | 951-852-7964
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Fax | 951-223-3956
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Provider Business Mailing Address
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Address Line | 36058 JOLTAIRE WAY
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City | WINCHESTER
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State | CA
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Zip | 92596-8741
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Country | US
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Telephone | 951-852-7964
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Fax | 951-223-3956
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. TIMOTHY JOHN HUNTINGTON
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Credential | PT
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Telephone | 952-223-3956
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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 | PT27996
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License Number State | CA
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