Organization
ANAHEIM PHYSICAL THERAPY AND AQUATIC REHAB
Active
Other names
Magnolia Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL M. FRACALOSY PT (OWNER)
(714) 808-0008
Entity
Organization
Contact information
Practice address
1189 N EUCLID ST, ANAHEIM, CA 92801-1938
(714) 808-0008
(714) 808-0168
Mailing address
1189 N EUCLID ST, ANAHEIM, CA 92801-1938
(714) 808-0008
(714) 808-0168
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
BUS2003-01454
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GPT001610
—
CA
Enumeration date
05/27/2006
Last updated
06/17/2008
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