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Organization
INNISS/NEILSON PHYSICAL THERAPY, INC.
Active
Organization
INNISS/NEILSON PHYSICAL THERAPY, INC.
Active
Other names
Bonita Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN NEILSON P.T. (C.E.O.)
(619) 422-3970
Entity
Organization
Contact information
Practice address
264 LANDIS AVE STE 103, CHULA VISTA, CA 91910-2651
(619) 422-3970
Mailing address
264 LANDIS AVE STE 103, CHULA VISTA, CA 91910-2651
(619) 422-3970
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 16623
CA
Other
Enumeration date
08/31/2006
Last updated
07/21/2022
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