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General NPI Number Information
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NPI Number | 1982968954
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Entity Type | Organization
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Legal Business Name | FIXYOU ORTHO, LLC
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Dates
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Enumeration Date | 06/25/2012
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Last Update Date | 06/25/2012
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Provider Practice Location Address
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Address Line | 1345 MORAGA DR
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City | LOS ANGELES
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State | CA
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Zip | 90049-1647
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Country | US
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Telephone | 310-920-0991
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Fax |
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Provider Business Mailing Address
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Address Line | 1345 MORAGA DR
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City | LOS ANGELES
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State | CA
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Zip | 90049-1647
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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 | PRESIDENT
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Name | MISS LIZA VISMANOS
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Credential |
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Telephone | 310-920-0991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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