Organization
WATER'S EDGE PHYSICAL THERAPY AND WELLNESS, INC.
Active
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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