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NPI 1962046326

NPI 1962046326 : KAREN STRATTON PT, OCS, MTC : SAN DIEGO, CA

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General NPI Number Information
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    NPI Number           |    1962046326
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    Entity Type          |    Individual 
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    Provider Name        |    KAREN STRATTON PT, OCS, MTC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/29/2019
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    Last Update Date     |    10/29/2019
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Provider Practice Location Address
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    Address Line         |    15004 INNOVATION DR 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92128-3491
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    Country              |    US
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    Telephone            |    858-605-7189
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10790 RANCHO BERNARDO RD # 4S-205 
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    City                 |    SAN DIEGO
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    State                |    CA
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    Zip                  |    92127-5705
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    Country              |    US
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    Telephone            |    858-927-5775
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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        |    2251S0007X
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    Taxonomy Name        |    Sports Physical Therapist
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    License Number       |    PT22332
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    License Number State |    CA
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