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Organization
EVOLVE INTEGRATED WELLNESS AND PHYSICAL THERAPY PC
Active
Organization
EVOLVE INTEGRATED WELLNESS AND PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. DAWN-MARIE ICKES M.P.T. (OWNER)
(818) 822-1600
Entity
Organization
Contact information
Practice address
30085 COMERCIO, RANCHO SANTA MARGARITA, CA 92688-2106
(818) 822-1600
Mailing address
30085 COMERCIO, RANCHO SANTA MARGARITA, CA 92688-2106
(818) 822-1600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
22362
CA
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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