Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 12457 | CA |
NPI | 1063622231 |
---|---|
Provider Name | Kathleen Marie Hoeck |
First Address | San Diego, CA 92129-3503 |
Second Address | La Mesa, CA 91942-3307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |