Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 10057 | TN |
N | 225100000X | Physical Therapist | 1245138 | TX |
Y | 225100000X | Physical Therapist | 41813 | CA |
NPI | 1003224072 |
---|---|
Provider Name | Crystal Mcmahon |
First Address | Visalia, CA 93291-6015 |
Second Address | Clovis, CA 93611-9206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 01/07/2021 |