Provider Demographics
NPI:1831564756
Name:MUV PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:MUV PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOLLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZSIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:714-222-0053
Mailing Address - Street 1:5650 EL CAMINO REAL
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7124
Mailing Address - Country:US
Mailing Address - Phone:760-919-2688
Mailing Address - Fax:
Practice Address - Street 1:5650 EL CAMINO REAL
Practice Address - Street 2:SUITE 120
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7124
Practice Address - Country:US
Practice Address - Phone:760-919-2688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA241562251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty