Provider Demographics
NPI:1306172150
Name:KINETICORE PILATES AND PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:KINETICORE PILATES AND PHYSICAL THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-585-0400
Mailing Address - Street 1:23 MAUCHLY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-5337
Mailing Address - Country:US
Mailing Address - Phone:949-585-0400
Mailing Address - Fax:949-585-0400
Practice Address - Street 1:23 MAUCHLY
Practice Address - Street 2:SUITE 108
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-5337
Practice Address - Country:US
Practice Address - Phone:949-585-0400
Practice Address - Fax:949-585-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty