Provider Demographics
NPI:1588236707
Name:BIOFIX PHYSICAL THERAPY AND FITNESS INC
Entity Type:Organization
Organization Name:BIOFIX PHYSICAL THERAPY AND FITNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:949-446-9739
Mailing Address - Street 1:24275 TAHOE CT
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-7024
Mailing Address - Country:US
Mailing Address - Phone:949-294-9079
Mailing Address - Fax:
Practice Address - Street 1:25422 TRABUCO RD STE 101
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-2790
Practice Address - Country:US
Practice Address - Phone:949-294-9079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty