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General NPI Number Information
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NPI Number | 1447630975
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Entity Type | Organization
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Legal Business Name | LEONA GERAGHTY
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 05/29/2015
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Provider Practice Location Address
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Address Line | 4352 ARBOR COVE CIR
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City | OCEANSIDE
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State | CA
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Zip | 92058-6954
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Country | US
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Telephone | 760-579-2868
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Fax |
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Provider Business Mailing Address
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Address Line | 4352 ARBOR COVE CIR
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City | OCEANSIDE
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State | CA
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Zip | 92058-6954
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Country | US
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Telephone | 760-579-2868
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | LEONA GERAGHTY
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Credential | PTA
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Telephone | 760-579-2868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | AT2949
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License Number State | CA
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