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Organization
FUNCTION FOR LIFE PHYSICAL THERAPY, INC.
Active
Organization
FUNCTION FOR LIFE PHYSICAL THERAPY, INC.
Active
Other names
Longevity Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRETT WILLIAM BLOOM P.T., D.P.T. (CEO/OWNER)
(760) 918-9200
Entity
Organization
Contact information
Practice address
2719 LOKER AVE W STE A, CARLSBAD, CA 92010-6679
(760) 918-9200
(760) 918-9203
Mailing address
1084 N EL CAMINO REAL # B-351, ENCINITAS, CA 92024-1334
(760) 918-9200
(760) 918-9203
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/25/2011
Last updated
01/25/2024
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