Organization
ERIC J. LAUDENSLAGER
Active
Other names
Yucaipa Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC LAUDENSLAGER M.P.T. (PT/OWNER)
(909) 797-5155
Entity
Organization
Contact information
Practice address
1630 W REDLANDS BLVD, L, REDLANDS, CA 92373-8032
(909) 797-5155
(909) 797-2768
Mailing address
33492 OAK GLEN RD, H, YUCAIPA, CA 92399-2096
(909) 797-5155
(909) 797-2768
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT8450
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PT84502
MEDICARE PTAN
CA
Enumeration date
09/14/2007
Last updated
08/18/2008
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