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General NPI Number Information
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NPI Number | 1902853310
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Entity Type | Organization
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Legal Business Name | KINETIX ADVANCED PHYSICAL THERAPY, INC.
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 25176 RYE CANYON RD
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City | VALENCIA
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State | CA
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Zip | 91355
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Country | US
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Telephone | 661-288-0300
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Fax | 661-288-0388
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Provider Business Mailing Address
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Address Line | 23501 CINEMA DRIVE SUITE 116
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City | VALENCIA
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State | CA
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Zip | 91355
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Country | US
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Telephone | 661-288-0300
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Fax | 661-288-0388
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. TIMOTHY FRANKLIN ECKARD
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Credential | MSPT, CERT. MDT
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Telephone | 661-288-0300
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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 30318
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License Number State | CA
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