Organization Name: | COSTA SPORTS PHYSICAL THERAPY INC |
NPI Number: | 1184088379 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARY COSTA (OWNER/PHYSICAL THERAPIST) |
Mailing Address: | 1041 E Yorba Linda Blvd Suite 209 Placentia |
State: | CA US |
Postal Code: | 928703728 |
Phone Number: | 7148311844 |
Fax Number: | 9494822122 |
NPI Enumeration Date: | 04/13/2016 |
NPI Last Update Date: | 05/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251C2600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Cardiopulmonary |
Taxonomy Definition: |