Provider Demographics
NPI:1831705862
Name:INTEGRATED PT & WELLNESS DBA THE HEIGHTS PHYSICAL THERAPY
Entity type:Organization
Organization Name:INTEGRATED PT & WELLNESS DBA THE HEIGHTS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PUCHNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-522-2661
Mailing Address - Street 1:256 REDONDO AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5950
Mailing Address - Country:US
Mailing Address - Phone:562-522-2661
Mailing Address - Fax:
Practice Address - Street 1:3620 LONG BEACH BLVD STE C11
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-6016
Practice Address - Country:US
Practice Address - Phone:714-329-9105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRATED PT & WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty