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Organization
PROSPORT PHYSICAL THERAPY PROFESSIONALS INC
Active
Organization
PROSPORT PHYSICAL THERAPY PROFESSIONALS INC
Active
Other names
ProSport Physical Therapy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY ISMAIL DPT (PRESIDENT)
(209) 353-1988
Entity
Organization
Contact information
Practice address
2777 BRISTOL ST, STE B, COSTA MESA, CA 92626-5997
(949) 250-1112
(949) 250-1401
Mailing address
PO BOX 14155, ORANGE, CA 92863-1555
(714) 450-4999
(714) 974-0055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/19/2006
Last updated
12/06/2023
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