Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 2000026361 | CA |
NPI | 1063932697 |
---|---|
Provider Name | Claudia Fotiou |
First Address | Pasadena, CA 91104-2901 |
Second Address | Valley Village, CA 91607-4122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2017 |
Last Update Date | 24/06/2017 |