Function for Life Pt INC
NPI #1811310170 in Encinitas, California
Provider Information
- NPI Number
- 1811310170
- Entity Type
- Organization
- Organization Name
- Function for Life Pt INC
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- Jan 22, 2014
- Last Updated
- Jan 22, 2014
Practice Location
- Address
- 227 N EL CAMINO REAL SUITE 103
- City
- Encinitas
- State
- California
- ZIP Code
- 92024
- Phone
- (760) 230-2316
Authorized Official
- Name
- BRETT BLOOM, DPT
- Title
- CFO, OWNER
- Phone
- (760) 230-2316
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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