Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 29182 | CA |
NPI | 1043419583 |
---|---|
Provider Name | Mr. Rhad Brown |
First Address | Santee, CA 92071 |
Second Address | Santee, CA 92071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2007 |
Last Update Date | 08/10/2020 |