Skyfall Physical Therapy
Physical Therapist in Los Angeles, CA. Organization (NPI-2).
NPI number1982126728
StatusActive
Last updated in NPPESApr 16, 2021
Details
- NPI
- 1982126728
- Entity type
- Organization (NPI-2)
- Legal business name
- Skyfall Physical Therapy
- Organization subpart
- No
- Enumeration date
- Jul 13, 2017
- Certification date
- Apr 16, 2021
- Last updated
- Apr 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
11677 San Vicente Blvd Ste 207Los Angeles, CA 90049-5128
Phone 310-743-6649
Mailing address
Po Box 491471Los Angeles, CA 90049-9471
Phone 310-743-6649
Authorized official
Theresa Ketterhagen
President
3107436649
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