360 Wellness Physical Therapy
Physical Therapist in West Covina, CA. Organization (NPI-2).
NPI number1174095863
StatusActive
Last updated in NPPESDec 19, 2018
Details
- NPI
- 1174095863
- Entity type
- Organization (NPI-2)
- Legal business name
- 360 Wellness Physical Therapy
- Organization subpart
- No
- Enumeration date
- Dec 19, 2018
- Last updated
- Dec 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 2251C2600X | – | – | ||
| 2251G0304X | Physical Therapist, Geriatrics | – | – | |
| 2251N0400X | Physical Therapist, Neurology | – | – | |
| 2251S0007X | Physical Therapist, Sports | – | – | |
| 2251X0800X | Physical Therapist, Orthopedic | – | – | |
| 225200000X | Physical Therapy Assistant | – | – |
Practice location
501 S Vincent AveWest Covina, CA 91790-6712
Phone 909-570-7787
Mailing address
11 Rock Springs WayAzusa, CA 91702-6270
Phone 909-570-7787
Authorized official
Yurong Lu
President/Physical Therapist
9095707787
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