Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | ||
Y | 2251N0400X | Physical Therapist - Neurology | PT20892 | CA |
NPI | 1003460783 |
---|---|
Provider Name | Katherine Garcia |
First Address | Auburn, CA 95603-3620 |
Second Address | Grass Valley, CA 95945-5701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2019 |
Last Update Date | 06/01/2020 |