Doctor Name: | MR. RYAN HADDOCK |
NPI Number: | 1376936492 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PTLA |
License Number: | |
Business Practice Address: | 144 W Los Angeles Ave #110 Moorpark, CA - 930211898 |
Business Phone Number: | 8055521915 |
Business Fax Number: | 8055521991 |
Mailing Address: | 144 W Los Angeles Ave, #110 MOORPARK |
State: | CA |
Postal Code: | 930211898 |
Phone Number: | 8055521915 |
Fax Number: | 8055521991 |
NPI Enumeration Date: | 03/13/2015 |
NPI Last Update Date: | 03/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |