Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT294807 | CA |
NPI | 1528687928 |
---|---|
Provider Name | Josephine Hunt-Korn |
First Address | Redondo Beach, CA 90278-2502 |
Second Address | Culver City, CA 90232-2713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2020 |
Last Update Date | 15/04/2020 |