Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251P0200X | Physical Therapist - Pediatrics | 33159 | CA |
Y | 2251P0200X | Physical Therapist - Pediatrics | PT33159 | CA |
NPI | 1073812129 |
---|---|
Provider Name | Dr. Melissa Cole |
First Address | Orange, CA 92868-3808 |
Second Address | Orange, CA 92868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2011 |
Last Update Date | 06/09/2018 |