Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 18096 | CA |
NPI | 1003143389 |
---|---|
Provider Name | Beata Zegarowski |
First Address | Lafayette, CA 94549-2624 |
Second Address | Lafayette, CA 94549-2624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2009 |
Last Update Date | 07/11/2009 |