# ACTIVE SPORTS REHAB PHYSICAL THERAPY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Active Sports Rehab Physical Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194309542
- **Authorized official:** CHRIS BOLLIER (BUSINESS MANAGER)
- **Authorized official phone:** (562) 650-5294

## Contact information

- **Practice address:** 6850 LINCOLN AVE STE 205, BUENA PARK, CA 90620-4180
- **Practice address phone:** (714) 527-9240
- **Practice address fax:** (714) 527-9230
- **Mailing address:** 6850 LINCOLN AVE STE 205, BUENA PARK, CA 90620-4180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2021
- **Last updated:** 05/11/2021