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Organization
SPORTS INDUSTRIAL PHYSICAL THERAPY
Active
Organization
SPORTS INDUSTRIAL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAWRENCE WILLIAM CARTER P.T. (OWNER)
(951) 360-8333
Entity
Organization
Contact information
Practice address
10427 SAN SEVAINE WAY, STE K, MIRA LOMA, CA 91752-1199
(951) 360-8333
Mailing address
10427 SAN SEVAINE WAY, STE K, MIRA LOMA, CA 91752-1199
(951) 360-8333
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT8535
CA
Other
Enumeration date
07/30/2006
Last updated
08/22/2020
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