Organization
BODY PHYSICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN GUY CLAYBORNE PT (OWNER)
(310) 405-1945
Entity
Organization
Contact information
Practice address
822 S ROBERTSON BLVD STE 101, LOS ANGELES, CA 90035-1633
(310) 405-1945
(424) 335-0030
Mailing address
822 S ROBERTSON BLVD STE 101, LOS ANGELES, CA 90035-1633
(310) 405-1945
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962952333
—
FL
Enumeration date
12/21/2020
Last updated
12/21/2020
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