Organization
SEASIDE PERFORMANCE PHYSICAL THERAPY, APC
Active
Organization
SEASIDE PERFORMANCE PHYSICAL THERAPY, APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAITLIN MARIE MIKKELSEN DPT (OWNER)
(858) 717-2621
Entity
Organization
Contact information
Practice address
6102 AVENIDA ENCINAS STE G, CARLSBAD, CA 92011-1005
(760) 884-0301
(760) 560-4285
Mailing address
754 SNAPDRAGON ST, ENCINITAS, CA 92024-3346
(858) 717-2621
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/25/2023
Last updated
02/19/2024
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