Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT291989 | CA |
NPI | 1073046306 |
---|---|
Provider Name | Gregory Schuft |
First Address | Culver City, CA 90232-3923 |
Second Address | Culver City, CA 90232-3923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 04/04/2017 |