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Organization
ALPHA PHYSICAL THERAPY AND PERFORMANCE, INC
Active
Organization
ALPHA PHYSICAL THERAPY AND PERFORMANCE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN ROLAND BLAKE PT, DPT (PRESIDENT/OWNER)
(619) 829-6961
Entity
Organization
Contact information
Practice address
310 S TWIN OAKS VALLEY RD, SUITE 108, SAN MARCOS, CA 92078-4303
(619) 829-6961
Mailing address
2096 SUSAN CT, ESCONDIDO, CA 92026-1878
(619) 829-6961
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
PT38074
CA
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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