Provider Demographics
NPI:1396508396
Name:FULL MOTION PHYSICAL THERAPY SERVICES INC
Entity type:Organization
Organization Name:FULL MOTION PHYSICAL THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASTGIK
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSSHKARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-425-7785
Mailing Address - Street 1:107 S FAIR OAKS AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2082
Mailing Address - Country:US
Mailing Address - Phone:818-425-7785
Mailing Address - Fax:
Practice Address - Street 1:107 S FAIR OAKS AVE STE 216
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2082
Practice Address - Country:US
Practice Address - Phone:818-425-7785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy