Organization
EXERCISING ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE OBENAUS P.T. (SOLE PROPRIETOR)
(310) 871-6762
Entity
Organization
Contact information
Practice address
915C W FOOTHILL BLVD # 564, CLAREMONT, CA 91711-3304
(310) 871-6762
(909) 593-4883
Mailing address
915C W FOOTHILL BLVD # 564, CLAREMONT, CA 91711-3304
(310) 871-6762
(909) 593-4883
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942313846
NPI NUMBER FOR INDIVIDUAL
CA
Enumeration date
06/06/2007
Last updated
07/21/2008
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