Genesis Sports Performance INC
NPI #1679126320 in Lake Forest, California
Provider Information
- NPI Number
- 1679126320
- Entity Type
- Organization
- Organization Name
- Genesis Sports Performance INC
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Jul 22, 2019
- Last Updated
- Jul 22, 2019
Practice Location
- Address
- 22600 LAMBERT ST STE 1204F
- City
- Lake Forest
- State
- California
- ZIP Code
- 92630-1623
- Phone
- (949) 838-6686
Authorized Official
- Name
- LISA CAMPBELL, PT
- Title
- OWNER/PHYSICAL THERAPIST
- Phone
- (949) 838-6686
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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