Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003149360 |
---|---|
Provider Name | Ms. Cheryl Anne Floyd |
First Address | Susanville, CA 96130-5109 |
Second Address | Susanville, CA 96130-4918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2009 |
Last Update Date | 17/09/2009 |