Provider Demographics
NPI:1972186633
Name:SPOT PHYSICAL THERAPY INC
Entity Type:Organization
Organization Name:SPOT PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DALLAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-452-2722
Mailing Address - Street 1:411 S CENTRAL AVE.
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1601
Mailing Address - Country:US
Mailing Address - Phone:818-452-2722
Mailing Address - Fax:818-272-8632
Practice Address - Street 1:411 S CENTRAL AVE.
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1601
Practice Address - Country:US
Practice Address - Phone:818-940-6015
Practice Address - Fax:818-272-8632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy