| NPI | 1699840934 |
|---|---|
| Former Legal Business Name | MISSION BEACH WATER AND SPORTS PHYSICAL THERAPY, INC |
| Entity Type | Organization |
| Authorized Contact | SOPHIA HAMILTON Operations Manager 858-288-3597 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT23900) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT27239) |
| 225100000X Physical Therapist (Licence: CA PT20904) | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2014-08-14 |