Lisa Marie Hardimon
Physical Therapist - Sports
604 N Sepulveda Blvd
Manhattan Beach
, California 90266-5921
Lisa Marie Hardimon
Physical Therapist - Sports
604 N Sepulveda Blvd
Manhattan Beach
, California 90266-5921
(310) 374-1605
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About
Features
Specialties
- Physical Therapist - Sports
Languages spoken
- English
Location
First Address
- Lisa Marie Hardimon
- 604 N Sepulveda Blvd
- Manhattan Beach, CA
- Zip : 90266-5921
- Fax : (310) 374-1605
- Phone : (310) 376-2156
Second Address
- Lisa Marie Hardimon
- 604 N Sepulveda Blvd
- Manhattan Beach, CA
- Zip : 90266-5921
- Fax : (310) 374-1605
- Phone : (310) 376-2156
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251S0007X | Physical Therapist - Sports | PT19902 | CA |
National Provider Identifier
| NPI | 1528310547 |
|---|---|
| Provider Name | Lisa Marie Hardimon |
| First Address | Manhattan Beach, CA 90266-5921 |
| Second Address | Manhattan Beach, CA 90266-5921 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/10/2012 |
| Last Update Date | 12/02/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| PT19902 | PT LICENSE (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.