Organization
PROSPORT PHYSICAL THERAPY PROFESSIONALS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY ISMAIL (PRESIDENT)
(209) 353-1988
Entity
Organization
Contact information
Practice address
2777 BRISTOL ST STE B, COSTA MESA, CA 92626-5997
(949) 250-1112
Mailing address
PO BOX 14155, ORANGE, CA 92863-1555
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/21/2019
Last updated
12/06/2023
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