Organization
AT HOME PHYSICAL THERAPY
Active
Other names
n/a
Organization subpart
No
Provider details
NPI number
Authorized official
MAXINE ANN BALSOM-LATURNER PT (OWNER)
(805) 889-8795
Entity
Organization
Contact information
Practice address
5564 MURRIETA ST, VENTURA, CA 93003-4241
(805) 889-8795
(805) 650-1707
Mailing address
5564 MURRIETA ST, VENTURA, CA 93003-4241
(805) 889-8795
(805) 650-1707
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
9225
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT 9225
MEDICARE INDIVIDUAL INDENTIFICATION
CA
Enumeration date
06/19/2006
Last updated
03/01/2009
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