MEDICARE: MARY ELIZABETH HARMAN P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	13961	CA

General Provider Information

NPI Number	:	1427388537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH HARMAN P.T.

Provider Business Mailing Address
First Line	:	28371 HARVEST VIEW LN
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-1198
Country	:	US
Telephone Number	:	949-459-7528
Fax Number	:

Provider Business Practice Location Address
First Line	:	28371 HARVEST VIEW LN
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-1198
Country	:	US
Telephone Number	:	949-459-7528
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2010
Last Update Date	:	01/12/2010

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