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General NPI Number Information
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NPI Number | 1902127772
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Entity Type | Organization
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Legal Business Name | NOSEK PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 06/16/2010
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 26941 CABOT RD SUITE 124
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7030
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Country | US
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Telephone | 949-636-7678
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Fax |
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Provider Business Mailing Address
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Address Line | 26941 CABOT RD SUITE 124
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-7030
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | MRS. MARY JOANN NOSEK
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Credential | P.T.
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Telephone | 949-636-7678
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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 | 23144
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License Number State | CA
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