Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT18761 | CA |
N | 2251C2600X | Cardiopulmonary | PT18761 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | PT18761 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT18761 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT18761 | CA |
NPI | 1184757130 |
---|---|
Provider Name | Leif E Mcguire |
First Address | Fresno, CA 93730-0738 |
Second Address | Fresno, CA 93710-5866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 09/10/2007 |