Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 24933 | CA |
NPI | 1033458674 |
---|---|
Provider Name | Ms. Molly Anne Mcleod |
First Address | San Diego, CA 92123-2762 |
Second Address | San Diego, CA 92123-2762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2013 |
Last Update Date | 01/02/2013 |