Doctor Name: | CAMILLE CECELIA GRACE MEDLEY |
NPI Number: | 1073801908 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | PT 36791 |
Business Practice Address: | 11713 Star Jasmine Cir Moreno Valley, CA - 925576027 |
Business Phone Number: | 9514157379 |
Business Fax Number: | |
Mailing Address: | 11713 Star Jasmine Cir, MORENO VALLEY |
State: | CA |
Postal Code: | 925576027 |
Phone Number: | 9514157379 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2011 |
NPI Last Update Date: | 07/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT 36791 |
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 |