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General NPI Number Information
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NPI Number | 1649835307
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Entity Type | Individual
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Provider Name | CARRIE MICHELLE NOFZIGER PTA, B.A
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Gender | Female
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 7601 IMPERIAL HWY
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City | DOWNEY
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State | CA
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Zip | 90242-3456
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Country | US
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Telephone | 562-385-6239
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Fax |
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Provider Business Mailing Address
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Address Line | 6362 TRINETTE AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92845-2839
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Country | US
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Telephone | 562-260-9214
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | AT6760
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License Number State | CA
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