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Organization
IMPACT DANCE AND PHYSICAL THERAPY PC
Active
Organization
IMPACT DANCE AND PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE BLAIR TAYLOE PT, DPT (CLINIC OWNER)
(619) 666-2120
Entity
Organization
Contact information
Practice address
7857 CONVOY CT, SAN DIEGO, CA 92111-1221
(619) 666-2120
Mailing address
7857 CONVOY CT STE 211, SAN DIEGO, CA 92111-1221
(619) 666-2120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
Other
Enumeration date
10/07/2026
Last updated
10/07/2026
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