# ACTIVE PHYSICAL THERAPY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689886764
- **Authorized official:** RACHAEL M.E. LARSON P.T. (OWNER,PRESIDENT)
- **Authorized official phone:** (805) 878-9868

## Contact information

- **Practice address:** 1851 SHELL BEACH RD, SUITE B, SHELL BEACH, CA 93449
- **Practice address phone:** (805) 878-9868
- **Practice address fax:** (805) 556-0710
- **Mailing address:** 1851 SHELL BEACH RD, SUITE B, SHELL BEACH, CA 93449
- **Mailing address phone:** (805) 878-9868
- **Mailing address fax:** (805) 556-0710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT21474 | CA | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020