Provider Demographics
NPI:1770683625
Name:MORE THAN PHYSICAL THERAPY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:MORE THAN PHYSICAL THERAPY HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:J
Authorized Official - Last Name:LONGO
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:760-749-8874
Mailing Address - Street 1:27075 SUNNINGDALE WAY
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-6642
Mailing Address - Country:US
Mailing Address - Phone:760-297-4674
Mailing Address - Fax:760-749-2556
Practice Address - Street 1:27075 SUNNINGDALE WAY
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-6642
Practice Address - Country:US
Practice Address - Phone:760-297-4674
Practice Address - Fax:760-749-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20230A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEO226AMedicare PIN