Organization
RESTORATIVE THERAPY ASSOCIATES
Active
Organization
RESTORATIVE THERAPY ASSOCIATES
Active
Other names
MVP Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEREK DECICCO (OWNER)
(949) 855-0100
Entity
Organization
Contact information
Practice address
20431 JAMES BAY CIR, LAKE FOREST, CA 92630-8833
(949) 855-0100
(949) 855-0134
Mailing address
20431 JAMES BAY CIR, LAKE FOREST, CA 92630-8833
(949) 855-0100
(949) 855-0134
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
30301
CA
Other
Enumeration date
12/14/2010
Last updated
01/05/2015
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