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Organization
SOUTHSIDE PHYSICAL THERAPY AND TRAINING CENTER INC
Active
Organization
SOUTHSIDE PHYSICAL THERAPY AND TRAINING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR RAMON CARLOS DPT (PRESIDENT)
(714) 904-2918
Entity
Organization
Contact information
Practice address
24012 CALLE DE LA PLATA, SUITE 200, LAGUNA HILLS, CA 92653-3621
(714) 904-2918
(714) 965-5797
Mailing address
24012 CALLE DE LA PLATA, SUITE 200, LAGUNA HILLS, CA 92653-3621
(714) 904-2918
(714) 965-5797
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT26966
CA
225X00000X
Occupational Therapist
OT1503
CA
Other
Enumeration date
07/30/2008
Last updated
12/08/2008
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