Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT25807 | CA |
N | 2251C2600X | Cardiopulmonary | PT25807 | CA |
N | 2251E1200X | Ergonomics | PT25807 | CA |
N | 225XE1200X | Ergonomics | PT25807 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | PT25807 | CA |
N | 2251N0400X | Physical Therapist - Neurology | PT25807 | CA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT25807 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT25807 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT25807 | CA |
N | 225XH1200X | Occupational Therapist - Hand | PT25807 | CA |
NPI | 1831231703 |
---|---|
Provider Name | Rachel Georgeson |
First Address | Mammoth Lakes, CA 93546-0660 |
Second Address | Mammoth Lakes, CA 93546-0660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |