Provider Demographics
NPI:1831367135
Name:MADE IN LA PT INC
Entity type:Organization
Organization Name:MADE IN LA PT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-499-1990
Mailing Address - Street 1:6741 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-4604
Mailing Address - Country:US
Mailing Address - Phone:323-461-1990
Mailing Address - Fax:323-461-1995
Practice Address - Street 1:6741 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-4604
Practice Address - Country:US
Practice Address - Phone:323-461-1990
Practice Address - Fax:323-461-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty