Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 41636 | CA |
NPI | 1003217555 |
---|---|
Provider Name | Sarah Kathleen Wallington |
First Address | Ventura, CA 93003-3016 |
Second Address | Ventura, CA 93003-3016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2014 |
Last Update Date | 15/01/2016 |