Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 15103 | CA |
NPI | 1093881831 |
---|---|
Provider Name | Ms. Meryl Sherman Mccormack |
First Address | Danville, CA 94526-5049 |
Second Address | Danville, CA 94526-5049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 08/07/2007 |