| Blast Off Children's Therapy Services, Inc. | |
|
9520 Padgett St Suite 104 San Diego CA 92126-4445 | |
| (858) 866-8133 | |
| (858) 999-2002 |
| Full Name | Blast Off Children's Therapy Services, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 9520 Padgett St, San Diego, California |
| Authorized Official Name and Position | Luann H. Lower (PRESIDENT, CEO) |
| Authorized Official Contact | 8588668133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blast Off Children's Therapy Services, Inc. 9520 Padgett St Suite 104 San Diego CA 92126-4445 Ph: (858) 866-8133 | Blast Off Children's Therapy Services, Inc. 9520 Padgett St Suite 104 San Diego CA 92126-4445 Ph: (858) 866-8133 |
| NPI Number | 1518390616 |
|---|---|
| Provider Enumeration Date | 08/13/2013 |
| Last Update Date | 08/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518390616 | NPI | - | NPPES |
| 13795 | Other | CA | SLP LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 13795 (California) | Primary |
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