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General NPI Number Information
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NPI Number | 1396956876
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Entity Type | Individual
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Provider Name | MICHELE MUNSON DPT
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 10780 SANTA MONICA BLVD STE 110
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City | LOS ANGELES
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State | CA
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Zip | 90025-7613
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Country | US
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Telephone | 310-474-5150
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Fax |
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Provider Business Mailing Address
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Address Line | 303 FLEISCHMANN WAY
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City | CARSON CITY
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State | NV
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Zip | 89703-2913
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Country | US
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Telephone | 775-885-7827
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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 | 2629
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 30041
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License Number State | CA
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