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Organization
ORTHO SHOCK WAVE THERAPY, INC.
Active
Organization
ORTHO SHOCK WAVE THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE WILLETTS (CHIEF EXECUTIVE OFFICER)
(714) 966-9335
Entity
Organization
Contact information
Practice address
3636 HARBOR BLVD, H2, COSTA MESA, CA 92626
(714) 966-9335
(714) 966-9706
Mailing address
3303 HARBOR BLVD, SUITE H2, COSTA MESA, CA 92626-1530
(714) 966-9335
(714) 966-9706
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/12/2006
Last updated
08/22/2020
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