MEDICARE: A5 PHYSICAL THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2251C2600X	Cardiopulmonary Physical Therapist
2	2251G0304X	Geriatric Physical Therapist
3	2251N0400X	Neurology Physical Therapist
4	2251X0800X	Orthopedic Physical Therapist
5	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1104641463
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A5 PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	1305 WOODLOW CT
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-1756
Country	:	US
Telephone Number	:	617-605-0194
Fax Number	:

Provider Business Practice Location Address
First Line	:	29219 CANWOOD ST UNIT 107
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-1560
Country	:	US
Telephone Number	:	818-914-7559
Fax Number	:	818-914-7560

Authorized Official
Title or Position	:	CFO
Name	:	AJIT SANKHE
Credential	:	DPT
Telephone Number	:	617-605-0295

Provider Enumeration Date	:	11/20/2024
Last Update Date	:	11/20/2024

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Directions to “A5 PHYSICAL THERAPY INC ” Practice Location

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