Organization Name: | CPRX, INCORPORATED |
NPI Number: | 1174964670 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEREMY W MATTESON (OWNER) |
Mailing Address: | 2 Journey Suite 201 Aliso Viejo |
State: | CA US |
Postal Code: | 92656 |
Phone Number: | 5627994494 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2013 |
NPI Last Update Date: | 07/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | PT22434 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |