Organization
WATER AND SPORTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA HAMILTON (OFFICE MANAGER)
(858) 726-2624
Entity
Organization
Contact information
Practice address
3639 MIDWAY DR, B286, SAN DIEGO, CA 92110-5254
(858) 488-3597
(858) 724-1747
Mailing address
3639 MIDWAY DR, B286, SAN DIEGO, CA 92110-5254
(858) 488-3597
(858) 724-1747
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT40754
CA
Other
Enumeration date
12/16/2013
Last updated
12/16/2013
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