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NPI Code Detail

MEDICARE: EGGLETON LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES

MEDICARE: EGGLETON LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1225084056
Entity Type Code : Organization
Provider Name (Legal Business Name) : EGGLETON LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES
Provider Business Mailing Address
First Line : 5905 SEVERIN DR
Second Line :
City : LA MESA
State : CA
Zip : 91942-3806
Country : US
Telephone Number : 619-589-2606
Fax Number : 619-464-0900
Provider Business Practice Location Address
First Line : 2437 FENTON ST
Second Line : SUITE B
City : CHULA VISTA
State : CA
Zip : 91914-3517
Country : US
Telephone Number : 619-656-5176
Fax Number : 619-656-5173
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : SEAN MICHAEL MCKEOWN
Credential :
Telephone Number : 619-295-3000
Provider Enumeration Date : 05/25/2006
Last Update Date : 02/13/2018

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Directions to “EGGLETON LANGTON PHYSICAL THERAPY MANAGEMENT SERVICES ” Practice Location

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