Organization
REGENERATE PHYSICAL THERAPY AND PERFORMANCE
Active
Organization
REGENERATE PHYSICAL THERAPY AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL MORTIMER (CEO/OWNER)
(920) 941-0136
Entity
Organization
Contact information
Practice address
13337 TINING DR, POWAY, CA 92064-1220
(920) 941-0136
Mailing address
1401 21ST ST STE R, SACRAMENTO, CA 95811-5226
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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