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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