Provider Demographics
NPI:1942712203
Name:PROJECT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PROJECT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-315-9321
Mailing Address - Street 1:1055 TIERRA DEL REY STE A
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7875
Mailing Address - Country:US
Mailing Address - Phone:619-421-0444
Mailing Address - Fax:619-421-0434
Practice Address - Street 1:1055 TIERRA DEL REY STE A
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7875
Practice Address - Country:US
Practice Address - Phone:619-421-0444
Practice Address - Fax:619-421-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty