# ADVANCED DYNAMIC THERAPIES PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407046881
- **Authorized official:** MR. MATTHEW REDDICK PERRY R.P.T. (DIRECTOR)
- **Authorized official phone:** (323) 295-5836

## Contact information

- **Practice address:** 644 E REGENT ST, 101, INGLEWOOD, CA 90301-1433
- **Practice address phone:** (310) 330-1177
- **Practice address fax:** (310) 330-1188
- **Mailing address:** 644 E REGENT ST, 101, INGLEWOOD, CA 90301-1433
- **Mailing address phone:** (310) 330-1177
- **Mailing address fax:** (310) 330-1188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT16833 | CA | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 49951 | CA | — |

## Other

- **Enumeration date:** 07/31/2007
- **Last updated:** 09/21/2010