Organization
CAPACITY PHYSICAL THERAPY & SPORTS PERFORMANCE
Active
Organization
CAPACITY PHYSICAL THERAPY & SPORTS PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL BLAKE PERRYMAN DPT (OWNER AND PHYSICAL THERAPIST)
(817) 564-4623
Entity
Organization
Contact information
Practice address
21800 BARTON RD STE 109, GRAND TERRACE, CA 92313-4438
(817) 564-4623
Mailing address
12635 KINGFISHER RD, GRAND TERRACE, CA 92313-5720
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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