Organization
CBAD ENTERPRISES, INC
Active
Other names
Susan Croke Physical Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN LYNNE CROKE P.T. (PHYSICAL THERAPIST)
(760) 603-7900
Entity
Organization
Contact information
Practice address
6215 EL CAMINO REAL STE 100, ELITE PERFORMANCE INSTITUTE, CARLSBAD, CA 92009-1604
(760) 603-7900
(760) 603-7997
Mailing address
2588 EL CAMINO REAL, F249, CARLSBAD, CA 92008-1211
(760) 603-7900
(760) 603-7997
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT19837
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265480560
NPI
CA
01
—
PT 19837
PT LICENSE
CA
Enumeration date
01/08/2008
Last updated
01/08/2008
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