Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Aug 11, 2025
License(s)
308419 (CA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1650 LYNDON FARM CT STE 300 | Louisville, KY 40223-5005 | |
| LOCATION | 8901 ACTIVITY RD STE 200 | San Diego, CA 92126-4436 | 858-566-6673 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.