Organization
ACTIVE HEALTH PHYSICAL THERAPY, INC.
Active
Other names
Active Health Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANYA LEIGH MACLEOD PT, DPT (PRESIDENT)
(310) 994-4663
Entity
Organization
Contact information
Practice address
10585 SANTA MONICA BLVD, SUITE 100, LOS ANGELES, CA 90025-4921
(310) 994-4663
(310) 310-3865
Mailing address
911 7TH ST, SUITE D, SANTA MONICA, CA 90403-2779
(310) 994-4663
(310) 310-3865
Taxonomy
Speciality
Code
Description
License number
State
2251E1200X
Ergonomics Physical Therapist
32763
CA
2251S0007X
Sports Physical Therapist
32763
CA
2251X0800X
Orthopedic Physical Therapist
Primary
32763
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32763
PHYSICAL THERAPY LICENSE
CA
Enumeration date
11/07/2008
Last updated
02/19/2013
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