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General NPI Number Information
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NPI Number | 1932765807
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Entity Type | Organization
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Legal Business Name | FITFXNRX PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 2750 FOOTHILL BLVD
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3517
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Country | US
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Telephone | 818-261-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 23735 DEL MONTE DR UNIT 170
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City | VALENCIA
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State | CA
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Zip | 91355-3376
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Country | US
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Telephone | 818-261-8511
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SUZANNE HAWSON
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Credential | PT
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Telephone | 818-261-8511
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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