Organization
ANAHEIM PHYSICAL THERAPY AND AQUATIC REHAB
Active
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
Update your record
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