Organization
BODY CENTER PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LAURENCE FAIRLEY PT, DPT, OCS (OWNER)
(626) 664-2827
Entity
Organization
Contact information
Practice address
224 N INDIAN HILL BLVD, CLAREMONT, CA 91711-4609
(909) 621-0447
(626) 821-5434
Mailing address
224 N INDIAN HILL BLVD, CLAREMONT, CA 91711-4609
(909) 621-0447
(626) 821-5434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT25533
CA
2251S0007X
Sports Physical Therapist
PT 25533
CA
2251X0800X
Orthopedic Physical Therapist
Primary
PT 25533
CA
Other
Enumeration date
10/04/2006
Last updated
03/13/2019
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