Bloomwell Pediatric Wellness And Physical Therapy INC
Physical Therapist, Pediatrics in Laguna Hills, CA. Organization (NPI-2).
NPI number1093416273
StatusActive
Last updated in NPPESMar 14, 2023
Details
- NPI
- 1093416273
- Entity type
- Organization (NPI-2)
- Legal business name
- Bloomwell Pediatric Wellness And Physical Therapy INC
- Organization subpart
- No
- Enumeration date
- Mar 14, 2023
- Certification date
- Mar 14, 2023
- Last updated
- Mar 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251P0200X | Physical Therapist, Pediatrics | – | – | Yes |
| 2251X0800X | Physical Therapist, Orthopedic | – | – |
Practice location
25255 Cabot Rd Ste 112Laguna Hills, CA 92653-5507
Phone 949-229-0170
Mailing address
25255 Cabot Rd Ste 112Laguna Hills, CA 92653-5507
Phone 949-229-0170
Authorized official
Taylor Henderson
Physical Therapist, Owner
9492290170
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