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General NPI Number Information
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NPI Number | 1023229002
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Entity Type | Individual
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Provider Name | LAURA JO HUSK PT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1900 BATES AVE
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City | CONCORD
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State | CA
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Zip | 94520-8587
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Country | US
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Telephone | 925-677-4240
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Fax |
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Provider Business Mailing Address
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Address Line | 328 KENTUCKY ST
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City | VALLEJO
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State | CA
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Zip | 94590-5040
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Country | US
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Telephone | 707-373-5017
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 26486
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License Number State | CA
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