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Organization
PRIME THERAPY SERVICES,LLC
Active
Organization
PRIME THERAPY SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALVIN LAZARO BANZUELA PT (PRESIDENT)
(310) 320-9905
Entity
Organization
Contact information
Practice address
21151 S WESTERN AVE, SUITE 132, TORRANCE, CA 90501-1724
(310) 320-9905
Mailing address
21151 S WESTERN AVE, SUITE 132, TORRANCE, CA 90501-1724
(310) 320-9905
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT24628
CA
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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