Provider Demographics
NPI:1932557576
Name:NEXT LEVEL PHYSICAL THERAPY AND ATHLETIC PERFORMANCE, PC
Entity Type:Organization
Organization Name:NEXT LEVEL PHYSICAL THERAPY AND ATHLETIC PERFORMANCE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:WUNSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-430-0005
Mailing Address - Street 1:23206 LYONS AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2671
Mailing Address - Country:US
Mailing Address - Phone:661-383-9828
Mailing Address - Fax:661-206-4153
Practice Address - Street 1:23206 LYONS AVE STE 105
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2671
Practice Address - Country:US
Practice Address - Phone:310-430-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy