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General NPI Number Information
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NPI Number | 1184711368
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Entity Type | Individual
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Provider Name | MS. LAUREEN A HARTSOOK
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9745 PROSPECT AVE
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City | SANTEE
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State | CA
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Zip | 92071-6209
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Country | US
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Telephone | 619-449-8946
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 333
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City | PINE VALLEY
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State | CA
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Zip | 91962-0333
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Country | US
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Telephone | 619-473-9017
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | AT2304
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License Number State | CA
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