Organization
INNOVATIVE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN S JOHNSON P.T. (PRESIDENT)
(619) 260-0750
Entity
Organization
Contact information
Practice address
5030 CAMINO DE LA SIESTA, SUITE 220, SAN DIEGO, CA 92108-3116
(619) 260-0750
(619) 260-0201
Mailing address
5030 CAMINO DE LA SIESTA, SUITE 220, SAN DIEGO, CA 92108-3116
(619) 260-0750
(619) 260-0201
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT12294
CA
Other
Enumeration date
05/09/2006
Last updated
03/06/2014
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