Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT36875 | CA |
NPI | 1386036101 |
---|---|
Provider Name | Melanie Barker |
First Address | Santa Monica, CA 90403-2719 |
Second Address | Santa Monica, CA 90403-2719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2015 |
Last Update Date | 03/03/2015 |