Provider First Line Business Practice Location Address:
16260 VENTURA BLVD SUITE 309
Provider Second Line Business Practice Location Address:
TAI PEDIATRIC PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
ENCINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91436-2276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-783-4071
Provider Business Practice Location Address Fax Number:
818-783-4081
Provider Enumeration Date:
12/05/2005