Provider Demographics
NPI:1740209212
Name:RESTORATIVE ARTS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:RESTORATIVE ARTS PHYSICAL THERAPY
Other - Org Name:CORE CONDITIONING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:CABOT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:818-907-0008
Mailing Address - Street 1:12930 VENTURA BLVD
Mailing Address - Street 2:SUITE 226A
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2200
Mailing Address - Country:US
Mailing Address - Phone:818-907-0008
Mailing Address - Fax:818-907-0088
Practice Address - Street 1:12930 VENTURA BLVD
Practice Address - Street 2:SUITE 226A
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2200
Practice Address - Country:US
Practice Address - Phone:818-907-0008
Practice Address - Fax:818-907-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty