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General NPI Number Information
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NPI Number | 1124677646
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Entity Type | Individual
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Provider Name | MACKENZIE SCHNEIDER-HARDING PT, DPT, MS, CSCS
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Gender | Male
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 3350 E BIRCH ST STE 160
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City | BREA
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State | CA
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Zip | 92821-6218
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Country | US
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Telephone | 714-528-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 615 E 3RD ST
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City | POMONA
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State | CA
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Zip | 91766-1906
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Country | US
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Telephone | 208-866-2575
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 297196
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License Number State | CA
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