Organization
SPECTRUM THERAPY AND SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENNY SOURAPAS (BILLING MRG)
(714) 526-3248
Entity
Organization
Contact information
Practice address
16 TECHNOLOGY DR STE 169, IRVINE, CA 92618-2328
(949) 872-2918
(949) 872-2072
Mailing address
16 TECHNOLOGY DR STE 169, IRVINE, CA 92618-2328
(949) 872-2918
(949) 872-2072
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
CA
Other
Enumeration date
03/29/2012
Last updated
03/29/2012
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