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Organization
ICONIC SPORTS PHYSICAL THERAPY PC
Active
Organization
ICONIC SPORTS PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY BANH PT, DPT (CEO, CFO, SECRETARY)
(909) 671-1553
Entity
Organization
Contact information
Practice address
1317 W FOOTHILL BLVD STE 100, UPLAND, CA 91786-3676
(626) 826-5921
Mailing address
1317 W FOOTHILL BLVD STE 100, UPLAND, CA 91786-3676
(909) 671-1553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/25/2026
Last updated
03/02/2026
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