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General NPI Number Information
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NPI Number | 1861876807
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Entity Type | Organization
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Legal Business Name | ARROYO GRANDE PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 07/18/2015
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Last Update Date | 07/18/2015
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Provider Practice Location Address
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Address Line | 117 S HALCYON RD
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3115
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Country | US
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Telephone | 805-481-5656
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Fax |
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Provider Business Mailing Address
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Address Line | 520 CARMELLA DR
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-3712
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Country | US
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Telephone | 805-748-7693
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Fax |
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Authorized Official
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Title or Position | PTA
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Name | CYNTHIA COESTERWHALLS
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Credential |
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Telephone | 805-748-7693
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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 | AT 3833
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License Number State | CA
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