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Organization
MOMENTUM PHYSICAL THERAPY
Active
Organization
MOMENTUM PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA LYNN DOUGHERTY MPT (PRESIDENT, CLINICAL DIRECTOR)
(310) 721-2955
Entity
Organization
Contact information
Practice address
11500 W OLYMPIC BLVD, SUITE 350, LOS ANGELES, CA 90064-1524
(310) 721-2955
Mailing address
11500 W OLYMPIC BLVD, SUITE 350, LOS ANGELES, CA 90064-1524
(310) 721-2955
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24774
CA
Other
Enumeration date
12/25/2006
Last updated
08/22/2020
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