=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134154602
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DARLENE SANTNER P.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2006
-----------------------------------------------------
Last Update Date | 10/15/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 735 H STREET
-----------------------------------------------------
City | ARCATA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-832-7240
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 114
-----------------------------------------------------
City | PETROLIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95558-0114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 707-832-7240
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 32740
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------