Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 32068 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 32068 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 32068 | CA |
NPI | 1245304781 |
---|---|
Provider Name | Mrs. Stephanie Loo |
First Address | Glendale, CA 91206-3813 |
Second Address | Glendale, CA 91202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |