Provider Demographics
NPI:1134301187
Name:THERAPRACTICS, LLC
Entity type:Organization
Organization Name:THERAPRACTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:714-397-0467
Mailing Address - Street 1:1121 W COLUMBINE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3833
Mailing Address - Country:US
Mailing Address - Phone:714-397-0467
Mailing Address - Fax:714-957-1347
Practice Address - Street 1:1700 ADAMS AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4865
Practice Address - Country:US
Practice Address - Phone:714-397-0467
Practice Address - Fax:714-957-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-02
Last Update Date:2007-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7334225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659565422OtherINDIVIDUAL NPI #