Provider Demographics
NPI:1962667147
Name:CENTURY THERAPY GROUP
Entity type:Organization
Organization Name:CENTURY THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:310-325-3338
Mailing Address - Street 1:3525 PACIFIC COAST HWY STE C
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6656
Mailing Address - Country:US
Mailing Address - Phone:310-325-3338
Mailing Address - Fax:310-325-3339
Practice Address - Street 1:3525 PACIFIC COAST HWY STE C
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6656
Practice Address - Country:US
Practice Address - Phone:310-325-3338
Practice Address - Fax:310-325-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-27
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 16059174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty