Organization
KOA CAPITAL LTD, INC.
Active
Other names
Manual Therapy LA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA VAN DYK DPT (PHYSICAL THERAPIST)
(310) 968-2800
Entity
Organization
Contact information
Practice address
9665 WILSHIRE BLVD STE 450, BEVERLY HILLS, CA 90212-2446
(310) 247-8414
(310) 247-9414
Mailing address
5061 HASKELL AVE, ENCINO, CA 91436-1548
(310) 968-2800
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
09/27/2019
Last updated
11/18/2019
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