Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 33069 | CA |
NPI | 1376615419 |
---|---|
Provider Name | Erin Vestal |
First Address | Lincoln, CA 95648-8803 |
Second Address | Lincoln, CA 95648-8803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 03/01/2022 |