Organization
MARK ANTHONY SPORTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ANTHONY PAYARES DPT (OWNER)
(310) 801-8879
Entity
Organization
Contact information
Practice address
112 S CATALINA AVE, SUITE 6, REDONDO BEACH, CA 90277-3384
(310) 801-8879
(866) 602-2994
Mailing address
112 S CATALINA AVE, SUITE 6, REDONDO BEACH, CA 90277-3384
(310) 801-8879
(866) 602-2994
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT38186
CA
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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