Organization
FULLMOTION PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB JAMES GLEASON MPT, OCS (PRESIDENT)
(949) 542-5000
Entity
Organization
Contact information
Practice address
31461 RANCHO VIEJO RD, STE 101, SAN JUAN CAPISTRANO, CA 92675-1864
(949) 542-5000
Mailing address
31461 RANCHO VIEJO RD, STE 101, SAN JUAN CAPISTRANO, CA 92675-1864
(949) 542-5000
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT29291
CA
Other
Enumeration date
05/31/2008
Last updated
12/03/2014
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