Doctor Name: | MELISSA PEDRENA DE BODA |
NPI Number: | 1033406343 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT30068 |
Business Practice Address: | 235 N Kenwood St Apt. A Glendale, CA - 912064288 |
Business Phone Number: | 6262729738 |
Business Fax Number: | |
Mailing Address: | 235 N Kenwood St, Apt. A GLENDALE |
State: | CA |
Postal Code: | 912064288 |
Phone Number: | 6262729738 |
Fax Number: | |
NPI Enumeration Date: | 07/07/2011 |
NPI Last Update Date: | 07/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT30068 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |