Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT13261 | CA |
NPI | 1023034352 |
---|---|
Provider Name | Pamela Andrea Leduc |
First Address | Penn Valley, CA 95946-9001 |
Second Address | Penn Valley, CA 95946-9001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |