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Organization

DOC & DEVO, INC.

Active
Other names
OrthoSport OC Physical Therapy
Organization subpart
No

Provider details

NPI number
Authorized official
KYLE LOUIS ULRICH PT, DPT (PHYSICAL THERAPIST/OWNER)
(949) 582-2555
Entity
Organization

Contact information

Practice address
26522 LA ALAMEDA STE 100, MISSION VIEJO, CA 92691-8579
(949) 582-2555
Mailing address
26522 LA ALAMEDA STE 100, MISSION VIEJO, CA 92691-8579
(949) 582-2555
(949) 582-3567

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT34242
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CB212387
MEDICARE ID
CA
Enumeration date
01/07/2014
Last updated
06/23/2014
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