=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922321397
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY RESOURCES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2010
-----------------------------------------------------
Last Update Date | 01/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1727 SWEETWATER RD STE 117
-----------------------------------------------------
City | NATIONAL CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91950-7651
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-434-2063
-----------------------------------------------------
Fax | 619-336-0201
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2441 E PLAZA BLVD
-----------------------------------------------------
City | NATIONAL CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91950-5101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-434-2063
-----------------------------------------------------
Fax | 619-336-0201
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY
-----------------------------------------------------
Name | MRS. EUGIELYN LIBERATO MONTERO
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 619-203-3051
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number | 225100000X
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------