Provider Demographics
NPI:1548694961
Name:LITTLEFIELD PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:LITTLEFIELD PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:DALY
Authorized Official - Last Name:LITTLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:855-454-3784
Mailing Address - Street 1:PO BOX 893337
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92589-3337
Mailing Address - Country:US
Mailing Address - Phone:855-454-3784
Mailing Address - Fax:855-454-3784
Practice Address - Street 1:41421 DATE ST STE 101
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-7079
Practice Address - Country:US
Practice Address - Phone:855-454-3784
Practice Address - Fax:855-454-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA 2205305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service