Organization
WEST COAST SPINE AND SPORTS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAY MANSON (CONTRACTING)
(951) 653-4480
Entity
Organization
Contact information
Practice address
6370 MAGNOLIA AVE, SUITE L140, RIVERSIDE, CA 92506-2405
(951) 774-0793
(951) 774-0783
Mailing address
6370 MAGNOLIA AVE, SUITE L140, RIVERSIDE, CA 92506-2405
(951) 774-0793
(951) 774-0783
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Enumeration date
07/19/2007
Last updated
06/21/2018
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