Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1093831067 |
---|---|
Provider Name | Cynthia Lynn Clemmensen |
First Address | Seal Beach, CA 90740-6038 |
Second Address | Long Beach, CA 90822-5201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/07/2007 |