Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | PT 20220 | CA |
NPI | 1962599423 |
---|---|
Provider Name | Ann Babcock |
First Address | Riverside, CA 92507-0728 |
Second Address | Riverside, CA 92507-0728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 07/05/2008 |