Organization
PACK PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRODIE JAMES PACK (OWNER)
(949) 443-0713
Entity
Organization
Contact information
Practice address
24582 DEL PRADO STE E, DANA POINT, CA 92629-3820
(949) 443-0713
Mailing address
PO BOX 3255, DANA POINT, CA 92629-8255
(949) 443-0713
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
28869
CA
Other
Enumeration date
08/12/2008
Last updated
10/27/2008
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