Organization
ACTIVE MOTION PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN JESSE TURNER P.T. (SHAREHOLDER)
(949) 533-2055
Entity
Organization
Contact information
Practice address
22600 LAMBERT ST STE 1204, LAKE FOREST, CA 92630-1623
(949) 533-2055
Mailing address
22600 LAMBERT ST STE 1204, LAKE FOREST, CA 92630-1623
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT228100
CA
Other
Enumeration date
09/26/2013
Last updated
09/26/2013
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