Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 20707 | CA |
NPI | 1003232448 |
---|---|
Provider Name | Kendra Monica Hill |
First Address | Davis, CA 95616-2684 |
Second Address | Travis Afb, CA 94535-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2014 |
Last Update Date | 10/03/2014 |