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Organization
POWELL PEDIATRIC THERAPY
Active
Organization
POWELL PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTEL ROSE POWELL MOT (OWNER)
(760) 685-7694
Entity
Organization
Contact information
Practice address
3185 CARR DR, OCEANSIDE, CA 92056
(760) 685-7694
(760) 692-1466
Mailing address
3185 CARR DR, OCEANSIDE, CA 92056
(760) 685-7694
(760) 692-1466
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10089
CA
225XP0200X
Pediatric Occupational Therapist
10089
CA
Other
Enumeration date
03/10/2014
Last updated
03/13/2018
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