# FUNCTIONAL TRAINING AND REHAB PHYSIOTHERAPY P.C. INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013699016
- **Authorized official:** NATHAN MCCLUSKY DPT (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (949) 202-9099

## Contact information

- **Practice address:** 40679 BIG BEAR BOULEVARD, \#3885, BIG BEAR LAKE, CA 92315
- **Practice address phone:** (949) 202-9099
- **Mailing address:** 40679 BIG BEAR BOULEVARD, \#3885, BIG BEAR LAKE, CA 92315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2023
- **Last updated:** 08/01/2023