Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT 7763 | CA |
NPI | 1730305970 |
---|---|
Provider Name | Ms. Judith Ann Verbanets |
First Address | Del Mar, CA 92014-3406 |
Second Address | La Mesa, CA 91941-3625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |