Organization
ADVANCED INTEGRATIVE MANUAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TURK CMT (OWNER/NEUROMUSCULAR THERAPIST)
(949) 877-6547
Entity
Organization
Contact information
Practice address
1532 NEWPORT BLVD, COSTA MESA, CA 92627
(949) 877-6547
Mailing address
1532 NEWPORT BLVD, COSTA MESA, CA 92627-3715
(949) 877-6547
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
225700000X
Massage Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53841
BUSINESS LICENSE
CA
Enumeration date
09/04/2018
Last updated
09/04/2018
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