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General NPI Number Information
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NPI Number | 1962114702
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Entity Type | Organization
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Legal Business Name | LONGO PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 29105 VALLEY CENTER RD STE 125
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City | VALLEY CENTER
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State | CA
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Zip | 92082-6536
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Country | US
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Telephone | 760-297-4688
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Fax | 888-529-1874
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Provider Business Mailing Address
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Address Line | 27075 SUNNINGDALE WAY
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City | VALLEY CENTER
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State | CA
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Zip | 92082-6642
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Country | US
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Telephone | 760-297-4688
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Fax | 888-529-1874
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. BRETT J LONGO
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Credential | PT
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Telephone | 760-297-4688
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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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