Provider Demographics
NPI:1053072900
Name:THEREX STATION PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:THEREX STATION PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:310-974-0456
Mailing Address - Street 1:4614 DEL AMO BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1939
Mailing Address - Country:US
Mailing Address - Phone:310-974-0456
Mailing Address - Fax:
Practice Address - Street 1:4614 DEL AMO BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-1939
Practice Address - Country:US
Practice Address - Phone:310-974-0456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy