Provider Demographics
NPI:1649921958
Name:SOLANA BEACH PHYSICAL THERAPY
Entity type:Organization
Organization Name:SOLANA BEACH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DANSSAERT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:858-755-6024
Mailing Address - Street 1:530 LOMAS SANTA FE DR STE G
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1346
Mailing Address - Country:US
Mailing Address - Phone:858-755-6024
Mailing Address - Fax:858-755-6377
Practice Address - Street 1:530 LOMAS SANTA FE DR STE G
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1346
Practice Address - Country:US
Practice Address - Phone:858-755-6024
Practice Address - Fax:858-755-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty