Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 300520 | CA |
N | 2251S0007X | Physical Therapist - Sports | 63698 | OR |
NPI | 1205444072 |
---|---|
Provider Name | Heather Harrower |
First Address | San Clemente, CA 92673-2808 |
Second Address | San Clemente, CA 92673-2808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2020 |
Last Update Date | 25/08/2021 |