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Organization

PROEDGE PHYSICAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARA SOGOL AMOLI MPT, C.S.C.S (OWNER)
(949) 679-7755
Entity
Organization

Contact information

Practice address
1124 MAIN ST, SUITE C, IRVINE, CA 92614-6760
(949) 679-7755
(949) 679-7755
Mailing address
P.O. BOX 13144, NEWPORT BEACH, CA 92658-5086
(949) 679-7755
(949) 679-7755

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
26792
CA

Other

Enumeration date
06/30/2009
Last updated
06/30/2009
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