Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 36677 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 36677 | CA |
NPI | 1144564907 |
---|---|
Provider Name | Mrs. France Bouchard-Gill |
First Address | Carlsbad, CA 92009-5174 |
Second Address | Carlsbad, CA 92009-5174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2012 |
Last Update Date | 19/11/2012 |