Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT34845 | CA |
NPI | 1033360219 |
---|---|
Provider Name | Ms. Lisa Marie Cuevas |
First Address | Fresno, CA 93720-1401 |
Second Address | Fresno, CA 93720-8013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2008 |
Last Update Date | 13/12/2011 |