Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 39224 | CA |
NPI | 1073056990 |
---|---|
Provider Name | Dorothy Trogler |
First Address | La Mesa, CA 91942-1548 |
Second Address | La Mesa, CA 91942-3034 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2016 |
Last Update Date | 25/11/2016 |