Organization Name: | EVOLUTION PHYSICAL THERAPY, INC |
NPI Number: | 1174601116 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARWIN FOGT (PRESIDENT) |
Mailing Address: | 11825 Major St Penthouse Suite Culver City |
State: | CA US |
Postal Code: | 902306356 |
Phone Number: | 3109156100 |
Fax Number: | 3109150100 |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 10/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT35833 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |