Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | ||
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251S0007X | Physical Therapist - Sports | ||
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1578877627 |
---|---|
Provider Name | Dr. Summer Lee Haviland |
First Address | Huntington Beach, CA 92646-9000 |
Second Address | Huntington Beach, CA 92646-9000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2010 |
Last Update Date | 31/07/2010 |