Provider Demographics
NPI:1265072003
Name:MOBILITY IN-HOME PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:MOBILITY IN-HOME PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:760-445-3408
Mailing Address - Street 1:1079 N VULCAN AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1723
Mailing Address - Country:US
Mailing Address - Phone:760-445-3408
Mailing Address - Fax:760-456-9739
Practice Address - Street 1:1079 N VULCAN AVE
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1723
Practice Address - Country:US
Practice Address - Phone:760-445-3408
Practice Address - Fax:760-456-9739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy