Provider Demographics
NPI:1871209627
Name:ANCHOR PHYSICAL THERAPY APC
Entity type:Organization
Organization Name:ANCHOR PHYSICAL THERAPY APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:BARTLESON
Authorized Official - Suffix:V
Authorized Official - Credentials:DPT PT
Authorized Official - Phone:310-982-0695
Mailing Address - Street 1:1147 SANDWOOD PLACE
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731
Mailing Address - Country:US
Mailing Address - Phone:310-982-0695
Mailing Address - Fax:310-548-5050
Practice Address - Street 1:643 W 6TH STREET
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731
Practice Address - Country:US
Practice Address - Phone:310-548-5984
Practice Address - Fax:310-548-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty