Organization
PURE PEDIATRIC THERAPY
Active
Organization
PURE PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSIE RUDZIK (DIRECTOR/OWNER)
(949) 916-1654
Entity
Organization
Contact information
Practice address
24012 CALLE DE LA PLATA, #355, LAGUNA HILLS, CA 92653-3621
(949) 916-1654
(949) 916-1658
Mailing address
24012 CALLE DE LA PLATA, #355, LAGUNA HILLS, CA 92653-3621
(949) 916-1654
(949) 916-1658
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/01/2009
Last updated
07/01/2009
Update your record
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