Aquatic Physical Therapy of Palm Desert Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

7254 Issued in CA

Legal business name

AQUATIC PHYSICAL THERAPY OF PALM DESERT INC

Practice address

74824 Lennon PL
Palm Desert, CA 92260-1901

Phone

(760) 568-9811

NPI assigned

Oct 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dwight Cornish, PT

Title

Director

Phone

(760) 568-9811

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1124279393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13888",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922553888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74824 LENNON PL",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922601901",
            "telephone_number": "760-568-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUATIC PHYSICAL THERAPY OF PALM DESERT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "CORNISH",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "760-568-9811",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "7254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.