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Organization

SOUTHLAND PHYSICAL THERAPY MISSION VIEJO CLINIC, PC

Active
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Organization

SOUTHLAND PHYSICAL THERAPY MISSION VIEJO CLINIC, PC

Active
Parent organization
SOUTHLAND PHYSICAL THERAPY, INC
Other names
Southland Physical Therapy
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTHLAND PHYSICAL THERAPY, INC
Authorized official
SHAWN JEFFREY MEAD DPT (CLINICAL MANAGER)
(949) 627-8800
Entity
Organization

Contact information

Practice address
25565 JERONIMO RD, MISSION VIEJO, CA 92691-2707
(949) 627-8800
(949) 627-8801
Mailing address
25565 JERONIMO RD, MISSION VIEJO, CA 92691-2707
(949) 627-8800
(949) 627-8801

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40531
CA

Other

Enumeration date
10/18/2016
Last updated
10/18/2016
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