Organization
CORPUS ART PHYSICAL THERAPY PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VLADISLAV SHUB P.T. (PRESIDENT)
(310) 312-1111
Entity
Organization
Contact information
Practice address
11860 WILSHIRE BLVD, 100, LOS ANGELES, CA 90025-6613
(310) 312-1111
(310) 312-1139
Mailing address
11860 WILSHIRE BLVD, 100, LOS ANGELES, CA 90025-6613
(310) 312-1111
(310) 312-1139
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT32430
LICENSE
CA
Enumeration date
05/26/2006
Last updated
08/22/2020
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