| NPI | 1669534053 |
|---|---|
| Doing Business As | PRO ACTIVE PHYSICAL THERAPY LAKEWOOD |
| Entity Type | Organization |
| Authorized Contact | ROBERT PACE COO 213-804-1712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 6695) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: CO 8927) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2019-12-31 |