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General NPI Number Information
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NPI Number | 1891726840
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Entity Type | Organization
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Legal Business Name | SOUTH COUNTY AQUATIC & PHYSICAL THERAPY CENTER, INC.
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 27882 FORBES RD # 100
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1219
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Country | US
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Telephone | 949-364-6888
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Fax | 949-364-6333
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Provider Business Mailing Address
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Address Line | 27882 FORBES RD # 100
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1219
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Country | US
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Telephone | 949-364-6888
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Fax | 949-364-6333
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Authorized Official
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Title or Position | PRESIDENT
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Name | JORDAN JESSE TURNER
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Credential | P.T.
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Telephone | 949-364-6888
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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 | PT 22810
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License Number State | CA
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