Provider Demographics
NPI:1508108440
Name:ADEPT PHYSICAL THERAPY SERVICES , P. C.
Entity Type:Organization
Organization Name:ADEPT PHYSICAL THERAPY SERVICES , P. C.
Other - Org Name:ADEPT PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DINAH
Authorized Official - Middle Name:DOMINGO
Authorized Official - Last Name:FELICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:760-889-5544
Mailing Address - Street 1:5576 FOXTAIL LOOP
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-7152
Mailing Address - Country:US
Mailing Address - Phone:760-889-5544
Mailing Address - Fax:
Practice Address - Street 1:5576 FOXTAIL LOOP
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-7152
Practice Address - Country:US
Practice Address - Phone:760-889-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 25676225100000X
PT 26095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty