# 360 WELLNESS PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1174095863
- **Authorized official:** YURONG LU (PRESIDENT/PHYSICAL THERAPIST)
- **Authorized official phone:** (909) 570-7787

## Contact information

- **Practice address:** 501 S VINCENT AVE, WEST COVINA, CA 91790-6712
- **Practice address phone:** (909) 570-7787
- **Mailing address:** 11 ROCK SPRINGS WAY, AZUSA, CA 91702-6270
- **Mailing address phone:** (909) 570-7787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 2251C2600X | Cardiopulmonary Physical Therapist | — | NULL | — |
| 2251C2600X | Cardiopulmonary Physical Therapist | — | — | — |
| 2251G0304X | Geriatric Physical Therapist | — | NULL | — |
| 2251G0304X | Geriatric Physical Therapist | — | — | — |
| 2251N0400X | Neurology Physical Therapist | — | NULL | — |
| 2251N0400X | Neurology Physical Therapist | — | — | — |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2251S0007X | Sports Physical Therapist | — | — | — |
| 2251X0800X | Orthopedic Physical Therapist | — | NULL | — |
| 2251X0800X | Orthopedic Physical Therapist | — | — | — |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |

## Other

- **Enumeration date:** 12/19/2018
- **Last updated:** 12/19/2018