Organization
PEDIATRIC PHYSICAL THERAPY & SERVICES, INC.
Active
Organization
PEDIATRIC PHYSICAL THERAPY & SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE Y LOE MA, ECSE (EXECUTIVE DIRECTOR)
(805) 772-6014
Entity
Organization
Contact information
Practice address
524 KENTUCKY ST, SAN LUIS OBISPO, CA 93405-1913
(805) 772-6014
(805) 772-8246
Mailing address
2585 IRONWOOD AVE, MORRO BAY, CA 93442-1755
(805) 772-6014
(805) 772-8246
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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