Organization
SPARK45 FITNESS AND PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE BORDENAVE (OWNER/CEO)
(773) 623-9527
Entity
Organization
Contact information
Practice address
550 MAPLE ST, B, CARPINTERIA, CA 93013-3559
(805) 275-3000
Mailing address
550 MAPLE ST, B, CARPINTERIA, CA 93013-3559
(805) 275-3000
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
42251
CA
Other
Enumeration date
12/11/2015
Last updated
02/12/2016
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