# ACTIVE LIFE PHYSICAL THERAPY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Active Physical Therapy & Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225330616
- **Authorized official:** MR. STEPHEN JASON WILKINS DPT (PRESIDENT)
- **Authorized official phone:** (323) 481-4697

## Contact information

- **Practice address:** 5065 HOLLYWOOD BLVD, SUITE 201, LOS ANGELES, CA 90027-6122
- **Practice address phone:** (323) 481-4697
- **Mailing address:** 5065 HOLLYWOOD BLVD STE 201, LOS ANGELES, CA 90027-6122
- **Mailing address phone:** (323) 665-7675

## Taxonomy

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

## Other

- **Enumeration date:** 11/17/2010
- **Last updated:** 02/27/2025