Organization
PROFORMANCE PHYSICAL THERAPY AND REHABILITATION, INC.
Active
Other names
PRO Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD E NELSON JR. PT (PRESIDENT)
(323) 655-9055
Entity
Organization
Contact information
Practice address
490 S SAN VICENTE BLVD STE 3, LOS ANGELES, CA 90048-4132
(323) 655-9055
(323) 655-9255
Mailing address
2309 PACIFIC AVE, MANHATTAN BEACH, CA 90266-2631
(323) 697-4046
(323) 655-9255
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT21545
CA
Other
Enumeration date
06/30/2005
Last updated
08/26/2020
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