Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 39355 | CA |
NPI | 1144851197 |
---|---|
Provider Name | Maxine Joyce |
First Address | San Diego, CA 92127-5705 |
Second Address | San Diego, CA 92128-3491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2020 |
Last Update Date | 29/01/2020 |