Organization
REPAIR SPORTS INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD S BEAUCHAMP PT, DPT, SCS,CSCS (OWNER)
(951) 699-0303
Entity
Organization
Contact information
Practice address
1500 S ANAHEIM BLVD, SUITE 160, ANAHEIM, CA 92805-6242
(714) 377-4314
Mailing address
16561 BOLSA CHICA ST, #107, HUNTINGTON BEACH, CA 92649-3594
(714) 377-4314
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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