Provider Demographics
NPI:1770734568
Name:THERA TOUCH PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:THERA TOUCH PHYSICAL THERAPY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIA CECILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GODOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-281-5906
Mailing Address - Street 1:6360 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 414
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5603
Mailing Address - Country:US
Mailing Address - Phone:323-852-1882
Mailing Address - Fax:323-852-1828
Practice Address - Street 1:6360 WILSHIRE BLVD
Practice Address - Street 2:SUITE 414
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5603
Practice Address - Country:US
Practice Address - Phone:323-852-1882
Practice Address - Fax:323-852-1828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty