Organization
ADVANCED DYNAMIC THERAPIES PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW REDDICK PERRY R.P.T. (DIRECTOR)
(323) 295-5836
Entity
Organization
Contact information
Practice address
644 E REGENT ST, 101, INGLEWOOD, CA 90301-1433
(310) 330-1177
(310) 330-1188
Mailing address
644 E REGENT ST, 101, INGLEWOOD, CA 90301-1433
(310) 330-1177
(310) 330-1188
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT16833
CA
332B00000X
Durable Medical Equipment & Medical Supplies
49951
CA
Other
Enumeration date
07/31/2007
Last updated
09/21/2010
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