MEDICARE: DYNAMIC HEALTH INSTITUTE INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172M00000X	Mechanotherapist

General Provider Information

NPI Number	:	1194920355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC HEALTH INSTITUTE INC.

Provider Business Mailing Address
First Line	:	4529 COLLEGE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4010
Country	:	US
Telephone Number	:	619-286-2500
Fax Number	:	619-265-9428

Provider Business Practice Location Address
First Line	:	4529 COLLEGE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4010
Country	:	US
Telephone Number	:	619-286-2500
Fax Number	:	619-265-9428

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. BARBARA LEE OHLSON
Credential	:
Telephone Number	:	619-286-2500

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	08/22/2020

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