Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 11689 | CA |
NPI | 1295364172 |
---|---|
Provider Name | Lauren Mary Rossman |
First Address | Pomona, CA 91767-2918 |
Second Address | Pomona, CA 91767-2918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2020 |
Last Update Date | 03/04/2020 |