Provider Demographics
NPI:1316154412
Name:INGLEWOOD PHYSICAL THERAPY INC.
Entity type:Organization
Organization Name:INGLEWOOD PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-673-9861
Mailing Address - Street 1:133 N PRAIRIE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-4878
Mailing Address - Country:US
Mailing Address - Phone:310-673-9861
Mailing Address - Fax:310-673-7856
Practice Address - Street 1:133 N PRAIRIE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4878
Practice Address - Country:US
Practice Address - Phone:310-673-9861
Practice Address - Fax:310-673-7856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty