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Organization
ANGELA K PRESCOTT
Active
Organization
ANGELA K PRESCOTT
Active
Other names
La Quinta Physical Therapy DBA Prescotts Sports Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA KAYLENE PRESCOTT PT (OWNER LICENSED PHYSICAL THERAPIST)
(760) 324-6400
Entity
Organization
Contact information
Practice address
78365 HIGHWAY 111, SUITE167, LA QUINTA, CA 92253-2071
(760) 324-6400
(760) 328-8216
Mailing address
78365 HIGHWAY 111, SUITE # 167, LA QUINTA, CA 92253-2071
(760) 324-6400
(760) 328-8216
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
2251S0007X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT193551
MEDICARE PTAN INDIVIDUAL
CA
01
—
ZZZ29525Z
MEDICARE PTAN GROUP
CA
Enumeration date
05/23/2007
Last updated
05/27/2014
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