Organization
AGELESS PHYSICAL THERAPY PC
Active
Other names
FOREVER YOUNG THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
NADER THEODORY PT (OWNER)
(714) 944-3289
Entity
Organization
Contact information
Practice address
1600 W COAST HWY STE G, NEWPORT BEACH, CA 92663-5000
(949) 272-3325
(949) 333-2962
Mailing address
1600 W COAST HWY STE G, NEWPORT BEACH, CA 92663-5000
(949) 272-3325
(949) 333-2962
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
04/13/2023
Last updated
08/18/2024
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