Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sport, Spine & Orthopedic

Organization Physical Therapist · NPI 1043305824

Sport, Spine & Orthopedic is a Physical Therapist in San Luis Obispo, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
Specialties on file
2

Practice location Address checks out

862 Meinecke Ave Ste 101
San Luis Obispo, CA 93405-3702
Phone: (805) 541-4714
Fax: (805) 541-4235
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT5452 (CA)
Physical Therapist Taxonomy 225100000X

Record details

NPI number1043305824
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles St Vincent — Owner/Physical Therapist · (805) 541-4717
NPI enumeratedOctober 4, 2006
Last updated in NPPESNovember 22, 2011
Mailing address862 Meinecke Ave, Suite 101, San Luis Obispo, CA 93405-3702

Other providers in San Luis Obispo