Provider Demographics
NPI:1578754214
Name:MA KARLYNNE LOPEZ SABALLA PHYSICAL THERAPY CORPORATION
Entity Type:Organization
Organization Name:MA KARLYNNE LOPEZ SABALLA PHYSICAL THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MA KARLYNNE
Authorized Official - Middle Name:LOPEZ
Authorized Official - Last Name:SABALLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:818-343-2631
Mailing Address - Street 1:18107 SHERMAN WAY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4582
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18107 SHERMAN WAY
Practice Address - Street 2:SUITE 202
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4582
Practice Address - Country:US
Practice Address - Phone:818-343-2631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty