Organization
ORTHOTHERAPETUCIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANIJEH EZATVAR (CEO)
(805) 375-0001
Entity
Organization
Contact information
Practice address
1000 NEWBURY RD STE 120, THOUSAND OAKS, CA 91320-6437
(805) 375-0001
(805) 375-2221
Mailing address
1000 NEWBURY RD STE 120, THOUSAND OAKS, CA 91320-6437
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2007
Last updated
09/21/2022
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