Look up the most recent NPI and PECOS records

State-Of-The-Art Physical Therapy, Inc.

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

2492 Walnut Ave Ste 140, Tustin, CA 92780-6953

PECOS Enrollment

Based on the most recent information from CMS, provider State-Of-The-Art Physical Therapy, Inc. does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1437179959
Provider Type
Organization
Full Name
State-Of-The-Art Physical Therapy, Inc.

Subpart
No
Enumeration Date
7/20/2006
Last Updated
8/22/2020

Contact Information

Practice Location

2492 Walnut Ave Ste 140, Tustin, CA 92780-6953

(714) 544-2188

(714) 544-2189

Mailing Location

2492 Walnut Ave Ste 140, Tustin, CA 92780-6953

(714) 544-2188

(714) 544-2189

Authorized Official

Wong, Brian William (Owner)

(714) 544-2188

Provider Taxonomies

Code	Description	License
Code 225100000X	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License PT13998 California
Code 225100000X	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License PT13997 California
Code 2251S0007X	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License PT13998 California
Code 2251X0800X	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License PT13997 California

State-Of-The-Art Physical Therapy, Inc.

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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