Organization
CBAD ENTERPRISES, INC
Active
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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