Organization
SOCAL KIDS PHYSICAL THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL IANNESSA MPT (OWNER)
(562) 810-3197
Entity
Organization
Contact information
Practice address
1945 PALO VERDE AVE STE 204, LONG BEACH, CA 90815-3445
(562) 247-3467
Mailing address
5869 E PAGEANTRY ST, LONG BEACH, CA 90808-3717
(562) 810-3197
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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