Lisa J Shepard DPT, OCS

NPI 1063420545 - Physical Therapist - 225100000X

NPI Details
NPI 1063420545
Gender Female
Enumeration Date 08/03/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1294 WEST 6TH STREET
SUITE 101
SAN PEDRO CA, 90732-2997, US
Phone (310) 547-1850
Fax (310) 547-1972
Business Location
1294 WEST 6TH STREET
SUITE 101
SAN PEDRO CA, 90732-2997, US
Phone (310) 547-1850
Fax (310) 547-1972
Toxanomy
Taxonomy Code 225100000X
License State California
License Number PT26466
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According to our database, Lisa J Shepard DPT, OCS NPI is 1063420545, taxonomy code is 225100000X and license number is PT26466, license state is located at California. Lisa J Shepard DPT, OCS physically located at 1294 West 6th Street, San Pedro CA, 90732-2997. NPI Number Lisa J Shepard DPT, OCS has the Individual type.

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1063420545 NPI number is provided on an as is basis without warranty of any kind. 1063420545 is maintained by the National Plan & Provider Enumeration System. The contents of Lisa J Shepard DPT, OCS are for informational purposes only.