Organization
TKL INDUSTRIES
Active
Other names
OrthoSport Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL PATRICK TAYLOR P.T. (PRESIDENT)
(949) 721-9400
Entity
Organization
Contact information
Practice address
20101 SW BIRCH ST, STE 140, NEWPORT BEACH, CA 92660-1748
(949) 721-9400
Mailing address
20101 SW BIRCH ST, STE 140, NEWPORT BEACH, CA 92660-1748
(949) 721-9400
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT16450
CA
Other
Enumeration date
06/03/2006
Last updated
05/28/2015
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