Organization
SURF AND TURF THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILLIAN DANIELLE STEWART PT, DPT, HPCS (EXECUTIVE DIRECTOR)
(616) 403-3848
Entity
Organization
Contact information
Practice address
31441 AVENIDA DE LA VIS, SAN JUAN CAPISTRANO, CA 92675-2401
(949) 312-7227
Mailing address
31441 AVENIDA DE LA VIS, SAN JUAN CAPISTRANO, CA 92675-2401
(949) 312-7227
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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