Organization
WATER'S EDGE PHYSICAL THERAPY AND WELLNESS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE CARPENTER DPT (PRESIDENT/ PT, DPT)
(831) 419-8856
Entity
Organization
Contact information
Practice address
1228 N COAST HIGHWAY 101 STE 120, 1230 N COAST HIGHWAY 101 SUITE 130, ENCINITAS, CA 92024-1493
(760) 479-9801
Mailing address
2033 SAN ELIJO AVE, 111, CARDIFF, CA 92007-1726
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
35208
CA
Other
Enumeration date
08/18/2013
Last updated
08/18/2013
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