Organization
KTST, INC.
Active
Other names
Marathon Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MANSOUR TAFRESHI D.C. (PRESIDENT)
(714) 534-1100
Entity
Organization
Contact information
Practice address
12832 GARDEN GROVE BLVD., SUITE B, GARDEN GROVE, CA 92843
(714) 534-1100
(714) 534-1140
Mailing address
12832 GARDEN GROVE BLVD., SUITE B, GARDEN GROVE, CA 92843
(714) 534-1100
(714) 534-1140
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT13590
CA
Other
Enumeration date
12/27/2005
Last updated
11/04/2008
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