Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1003044298 |
---|---|
Provider Name | Leda Bluitt |
First Address | Monrovia, CA 91016-4492 |
Second Address | West Covina, CA 91790-2138 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 06/04/2021 |