Provider Demographics
NPI:1861279549
Name:VENICE TRAINING SYSTEMS PHYSICAL THERAPY CORPORATION
Entity type:Organization
Organization Name:VENICE TRAINING SYSTEMS PHYSICAL THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MANREET
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-222-9666
Mailing Address - Street 1:2474 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291
Mailing Address - Country:US
Mailing Address - Phone:310-486-3437
Mailing Address - Fax:
Practice Address - Street 1:2474 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291
Practice Address - Country:US
Practice Address - Phone:310-486-3474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty